Individual
GARY J KUZNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3003 W DR MARTIN LUTHER KING JR BLVD, MAB-3RD FLOOR, TAMPA, FL 33607-6307
(813) 554-8983
(813) 443-8177
Mailing address
3003 W DR MLK BLVD FL JR3, TAMPA, FL 33607-6307
(813) 554-8983
(813) 443-8177
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9108861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015632100
—
FL
Enumeration date
07/14/2015
Last updated
04/07/2023
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