Provider Demographics
NPI:1023028792
Name:TEN-KATE, VERONICA L (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:L
Last Name:TEN-KATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152557
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-2557
Mailing Address - Country:US
Mailing Address - Phone:813-870-1600
Mailing Address - Fax:813-673-8777
Practice Address - Street 1:2123 W DR MLK BLVD
Practice Address - Street 2:STE 204
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-870-1600
Practice Address - Fax:813-673-8777
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73007208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052602907Medicaid