Potithavoranant, Katrina

Potithavoranant, Katrina is an individual health care provider with primary practice located at 620 10Th St N Ste 1E , Saint Petersburg FL 33705-1407. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Potithavoranant, Katrina can be contacted via phone (727) 824-3120.

Contact Information

Primary practice address
620 10Th St N Ste 1E Saint Petersburg FL 33705-1407
Phone: (727) 824-3120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9112237 Florida

Profile Details

NPI number 1710348479
LBN Legal business name Potithavoranant, Katrina
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2016
Last updated Aug 17th, 2023 - about last year

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 1710348479 NPPES
Florida MEDICAID 104661300

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