DR. DIANE MARIE KRUTZLER (NPI# 1073878872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073878872 |
| Entity Type | Individual |
| Full Name | DR. DIANE MARIE KRUTZLER |
| Credential | MD |
| Practice Address |
1400 Se Goldtree Dr Ste 102-104 Port St Lucie FL 34952-7582 |
| Practice Telephone | 7723358446 |
| Practice Fax Number | 7723358499 |
| Mailing Telephone | 7723358446 |
| Mailing Fax Number | 7723358499 |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2017-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 00000 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1400 SE GOLDTREE DR STE 102-104 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-7582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174521595 | Adam D Kurtin | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2005-07-09 |
| 1184025728 | Aimee Elizabeth Farmer | Physician Assistant | 1400 Se Goldtree Dr, Ste 103, Port St Lucie, FL 34952-7582 | 2014-09-15 |
| 1528371895 | Shoshana Deann Hacker | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2010-07-15 |
| 1982725230 | Jeffrey Alan Tucker | Physical Therapist | 1400 Se Goldtree Dr, Suite 205, Port St Lucie, FL 34952-7582 | 2007-04-03 |
| 1417067844 | Premier Physical Therapy Sport Medicine Inc | Physical Therapist | 1400 Se Goldtree Dr, Ste 205, Port St Lucie, FL 34952-7582 | 2006-08-30 |
| 1003849449 | Shane Donald Whiteley | Chiropractor | 1400 Se Goldtree Dr, # 207, Port St Lucie, FL 34952 | 2006-07-09 |
| 1528066941 | Rene Mario Loyola | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2005-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245529551 | Meshach P Heenatigala | Surgery | 293 Nw Peacock Blvd Ste 202, Port St Lucie, FL 34986 | 2011-04-07 |
| 1598887010 | Jon Robert Brown | Surgery | 1400 Se Goldtree Dr Ste 103, Port St Lucie, FL 34952-7582 | 2007-04-04 |
| 1013929439 | Rafael Quinones | Surgery | 295 Nw Peacock Blvd, Port St Lucie, FL 34986-2212 | 2006-08-13 |
| 1659387405 | Richard James | Surgery | 176 Nw Magnolia Lakes Blvd, Port St Lucie, FL 34986 | 2006-08-01 |
| 1528066958 | Matthew N Peebles | Surgery | 10050 Sw Innovation Way, Port St Lucie, FL 34987-2117 | 2005-07-11 |
| 1174521595 | Adam D Kurtin | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2005-07-09 |
| 1376956045 | Eric Duffy | Surgery | 1400 Se Goldtree Dr Ste 103, Port St Lucie, FL 34952-7582 | 2014-06-10 |
| 1942555289 | Atlantic Skin Surgery LLC | Surgery | 176 Nw Magnolia Lakes Blvd, Port St Lucie, FL 34986-3567 | 2012-07-23 |
| 1740543057 | Eric Williams Owings | Surgery | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2012-06-21 |
| 1356637110 | Ana Paula Machado-hopkins | Surgery | 1400 Se Goldtree Dr Ste 103, Port St Lucie, FL 34952-7582 | 2011-06-21 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.