Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME96742 | FL |
NPI | 1568567931 |
---|---|
Provider Name | Kathryn L Hall |
First Address | Tampa, FL 33619-8327 |
Second Address | Plant City, FL 33563-7116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 23/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276432600 | (05) | FL |
56619 | BCBS (01) | FL |
I65830 | (02) |