Individual
KURT KUMAR PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5797 ITHACA CIR E, LAKE WORTH, FL 33463-6752
(305) 684-5147
Mailing address
5797 ITHACA CIR E, LAKE WORTH, FL 33463-6752
(305) 684-5147
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5226516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21230000000X
—
FL
Enumeration date
08/07/2017
Last updated
07/21/2022
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