Basic Information
| Provider Information | |||||||||
| NPI: | 1700024973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUHAREK | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | |||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 GATEWAY CENTRE BLVD | ||||||||
| Address2: | SUITE # 200 | ||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337826138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275443900 | ||||||||
| FaxNumber: | 7275445577 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 GATEWAY CENTRE BLVD | ||||||||
| Address2: | SUITE # 200 | ||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337826138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275443900 | ||||||||
| FaxNumber: | 7275445577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2009 | ||||||||
| LastUpdateDate: | 01/27/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 2056452 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 306545600 | 05 | FL | MEDICAID |