Provider Demographics
NPI:1215032164
Name:KUBA, CATHERINE KLEIN (MPT, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:KLEIN
Last Name:KUBA
Suffix:
Gender:F
Credentials:MPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 NORTHDALE BLVD
Mailing Address - Street 2:SUITE 111W
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1864
Mailing Address - Country:US
Mailing Address - Phone:813-418-7350
Mailing Address - Fax:813-265-2504
Practice Address - Street 1:3450 E FLETCHER AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4655
Practice Address - Country:US
Practice Address - Phone:813-805-8102
Practice Address - Fax:813-443-0716
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20232225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist