Provider Demographics
NPI:1477391670
Name:VOUTSINAS, KATRINA JACQUELINE
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:JACQUELINE
Last Name:VOUTSINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2531
Mailing Address - Country:US
Mailing Address - Phone:727-430-2226
Mailing Address - Fax:
Practice Address - Street 1:12085 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9725
Practice Address - Country:US
Practice Address - Phone:813-397-5300
Practice Address - Fax:813-549-8145
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034156367A00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology