1598149072 NPI number — KEVIN CHRISTOPHER VOTTA CPT, MATCS

Table of content: KEVIN CHRISTOPHER VOTTA CPT, MATCS (NPI 1598149072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598149072 NPI number — KEVIN CHRISTOPHER VOTTA CPT, MATCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOTTA
Provider First Name:
KEVIN
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPT, MATCS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598149072
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8721 GUNN HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ODESSA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33556-3210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-406-0827
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13825 ICOT BLVD
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33760-3712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-406-0827
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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