Provider Demographics
NPI:1003502816
Name:MY KIT FREE FLORIDA LLC
Entity Type:Organization
Organization Name:MY KIT FREE FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-880-9759
Mailing Address - Street 1:6707 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1536
Mailing Address - Country:US
Mailing Address - Phone:727-800-9958
Mailing Address - Fax:855-552-3776
Practice Address - Street 1:6707 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1536
Practice Address - Country:US
Practice Address - Phone:727-800-9958
Practice Address - Fax:855-552-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty