1760483150 NPI number — ALLISON HUSLANDER KASTNER AUD

Table of content: ALLISON HUSLANDER KASTNER AUD (NPI 1760483150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760483150 NPI number — ALLISON HUSLANDER KASTNER AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASTNER
Provider First Name:
ALLISON
Provider Middle Name:
HUSLANDER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HULSLANDER
Provider Other First Name:
ALLISON
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
AUD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760483150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 COLUMBIA DRIVE
Provider Second Line Business Mailing Address:
SUITE 610
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-844-4900
Provider Business Mailing Address Fax Number:
813-844-4905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 COLUMBIA DRIVE
Provider Second Line Business Practice Location Address:
SUITE 610
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-844-4900
Provider Business Practice Location Address Fax Number:
813-844-4905
Provider Enumeration Date:
08/09/2005

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: 231H00000X , with the licence number:  AY1244 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: AY1244 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: S2780 . This is a "BC/BS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: U1990Y . This is a "PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 33023 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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