Provider Demographics
NPI:1467038505
Name:TOTH, KAITLIN ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:ANN
Last Name:TOTH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 DEER LODGE CIR UNIT 108
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8546
Mailing Address - Country:US
Mailing Address - Phone:772-708-9047
Mailing Address - Fax:
Practice Address - Street 1:6639 SOUTHPOINT PKWY STE 103
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8042
Practice Address - Country:US
Practice Address - Phone:904-296-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist