Provider Demographics
NPI:1225122997
Name:PET SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:PET SERVICES OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-795-9729
Mailing Address - Street 1:PO BOX 2463
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34423-2463
Mailing Address - Country:US
Mailing Address - Phone:352-795-9729
Mailing Address - Fax:352-795-9262
Practice Address - Street 1:3404 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-3569
Practice Address - Country:US
Practice Address - Phone:352-746-6888
Practice Address - Fax:352-795-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0103Medicare PIN