Carlisle, Kevin K

Carlisle, Kevin K is an sole proprietor health care provider with primary practice located at 12880 Commodity Pl , Tampa FL 33626-3101. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Carlisle, Kevin K can be contacted via phone (813) 343-5500.

Contact Information

Primary practice address
12880 Commodity Pl Tampa FL 33626-3101
Phone: (813) 343-5500
Fax: (866) 462-7445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA1682 Florida

Profile Details

NPI number 1669467833
LBN Legal business name Carlisle, Kevin K
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2005
Last updated Oct 29th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669467833 NPPES
Florida Other 650420578 CHAMPUS/TRICARE
Florida Other X1592 CHAMPUS/TRICARE
Florida MEDICAID 290188900 CHAMPUS/TRICARE

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