Individual
DR. LAUREN VAN ELDIK KUYKENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, MDC 41, TAMPA, FL 33612
(813) 844-7412
(813) 974-8359
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME135803
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100668000
—
FL
01
—
JN604
MEDICARE
FL
01
—
LJM10
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/30/2012
Last updated
03/31/2021
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