Provider Demographics
NPI:1275152225
Name:KRAVATZ, NATALYA CERBITO (OD)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:CERBITO
Last Name:KRAVATZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-3454
Mailing Address - Country:US
Mailing Address - Phone:716-308-0894
Mailing Address - Fax:
Practice Address - Street 1:8150 CITRUS PARK TOWN CENTER MALL SPC 1100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3181
Practice Address - Country:US
Practice Address - Phone:813-920-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5864152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist