Provider Demographics
NPI:1265855860
Name:SANTANNA-KAHLOWSKY, TANIT M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TANIT
Middle Name:M
Last Name:SANTANNA-KAHLOWSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TANIT
Other - Middle Name:M
Other - Last Name:KAHLOWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:9150 WHISTABLE WALK
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4173
Mailing Address - Country:US
Mailing Address - Phone:954-274-9030
Mailing Address - Fax:
Practice Address - Street 1:9150 WHISTABLE WALK
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4173
Practice Address - Country:US
Practice Address - Phone:954-274-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine