Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 140218 | FL |
NPI | 1376986521 |
---|---|
Provider Name | Dr. Kristine Day Brentz |
First Address | Tampa, FL 33607-6330 |
Second Address | Tampa, FL 33607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 25/06/2019 |