Organization
KENVELO2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARD TSYRULNYKOV (OWNER)
(414) 915-5665
Entity
Organization
Contact information
Practice address
66 W FLAGLER ST STE 900, MIAMI, FL 33130-1807
(414) 915-5665
Mailing address
66 W FLAGLER ST STE 900, MIAMI, FL 33130-1807
(414) 915-5665
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/04/2022
Last updated
08/21/2023
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