Kruse Consulting Inc | |
645 W Lumsden Rd Brandon FL 33511-5911 | |
(813) 654-9322 | |
(813) 643-1457 |
Full Name | Kruse Consulting Inc |
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Speciality | Psychologist |
Location | 645 W Lumsden Rd, Brandon, Florida |
Authorized Official Name and Position | Steven John Kruse (PRESIDENT) |
Authorized Official Contact | 8136549322 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kruse Consulting Inc 645 W Lumsden Rd Brandon FL 33511-5911 Ph: (813) 654-9322 | Kruse Consulting Inc 645 W Lumsden Rd Brandon FL 33511-5911 Ph: (813) 654-9322 |
NPI Number | 1780934661 |
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Provider Enumeration Date | 09/18/2012 |
Last Update Date | 09/18/2012 |
Medicare PECOS PAC ID | 8527217090 |
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Medicare Enrollment ID | O20120927000670 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780934661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PY 5932 (Florida) | Primary |
Provider Name | Steven J Kruse |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1124077367 PECOS PAC ID: 5092965590 Enrollment ID: I20200519001963 |
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