Kolettis Krew Llc

LBN: Kolettis Krew Llc
Kolettis Krew Llc is an health care organization with primary practice located at 701 N. Hercules Ave Ste B, Clearwater FL 33765-2029. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Kolettis Krew Llc can be contacted via phone (727) 738-8410, or through Kolettis, Elias M via phone (727) 738-8410.

Contact Information

Primary practice address
701 N. Hercules Ave Ste B Clearwater FL 33765-2029
Fax: (727) 734-6254
Website:
Authorized official contact:
Name: Kolettis, Elias M Doctor of Osteopathy (DO)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X OS0007623 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Florida

Profile Details

NPI number 1457533762
LBN Legal business name Kolettis Krew Llc
DBA Doing business as
Authorized official Kolettis, Elias M Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2007
Last updated Mar 24th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457533762 NPPES
Florida Other 46556 BCBS
Florida Other 2161129 BCBS
Florida MEDICAID 255469100 BCBS

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