Provider Demographics
NPI:1568063238
Name:PANAWASH, KATELYN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:
Last Name:PANAWASH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:PANAWASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:9114 CANBERLEY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2221
Mailing Address - Country:US
Mailing Address - Phone:262-719-5623
Mailing Address - Fax:
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program