Provider Demographics
NPI:1871946327
Name:LAURITANO, KATHLEEN M (ARNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:LAURITANO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6101 WEBB RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2872
Mailing Address - Country:US
Mailing Address - Phone:813-269-6426
Mailing Address - Fax:813-342-5261
Practice Address - Street 1:6101 WEBB RD
Practice Address - Street 2:SUITE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2872
Practice Address - Country:US
Practice Address - Phone:813-269-6426
Practice Address - Fax:813-342-5261
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 3341742207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine