Basic Information
| Provider Information | |||||||||
| NPI: | 1154697738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUYKENDALL | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | TUCKER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12901 BRUCE B DOWNS BLVD # 41 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336124742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132590875 | ||||||||
| FaxNumber: | 8132598748 | ||||||||
| Practice Location | |||||||||
| Address1: | 12901 BRUCE B DOWNS BLVD # 41 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336124742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132590875 | ||||||||
| FaxNumber: | 8132598748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2012 | ||||||||
| LastUpdateDate: | 06/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | ME 120230 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.