Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4301058691 | MI |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME69927 | FL |
NPI | 1073627154 |
---|---|
Provider Name | Kathleen Allison Buran |
First Address | Tampa, FL 33625 |
Second Address | Tampa, FL 33625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 23/02/2012 |