Provider Demographics
NPI:1336123207
Name:HUGUET, KEVIN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LEE
Last Name:HUGUET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 9TH AVE N STE 270
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7149
Mailing Address - Country:US
Mailing Address - Phone:727-357-6447
Mailing Address - Fax:727-356-6447
Practice Address - Street 1:2191 9TH AVE N STE 270
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7149
Practice Address - Country:US
Practice Address - Phone:727-357-6447
Practice Address - Fax:727-356-6447
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85676208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ113286Medicaid
FL29063OtherBCBS FL
AZ113286Medicaid
FL29063OtherBCBS FL