1740640663 NPI number — MRS. KATHLEEN MARIE BITTINGER RBT

Table of content: MRS. KATHLEEN MARIE BITTINGER RBT (NPI 1740640663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740640663 NPI number — MRS. KATHLEEN MARIE BITTINGER RBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BITTINGER
Provider First Name:
KATHLEEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RBT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EDER
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740640663
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8314 SW 196TH COURT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUNNELLON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34432-3598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-409-8734
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2102 SW 20TH PL
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34471-0861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-332-8588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2016

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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