Individual
RAYMOND KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11091 91ST AVE, SEMINOLE, FL 33772-3706
(727) 439-0980
Mailing address
11091 91ST AVE, SEMINOLE, FL 33772-3706
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703077789
MI
164W00000X
Licensed Practical Nurse
Primary
PN5153156
FL
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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