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Individual

JAYME A KUKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13813 METRO PKWY, FORT MYERS, FL 33912-4343
(239) 936-1343
Mailing address
PO BOX 7006, FORT MYERS, FL 33911-7006
(239) 931-3440
(239) 931-3454

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4405
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AE289Y
MEDICARE
FL
Enumeration date
04/13/2007
Last updated
03/22/2012
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