Provider Demographics
NPI:1578831426
Name:JOHN T. KINNARD D.C. P.A.
Entity Type:Organization
Organization Name:JOHN T. KINNARD D.C. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KINNARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC PA
Authorized Official - Phone:813-963-3348
Mailing Address - Street 1:326 W BEARSS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1266
Mailing Address - Country:US
Mailing Address - Phone:813-963-3348
Mailing Address - Fax:813-963-3152
Practice Address - Street 1:326 W BEARSS AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1266
Practice Address - Country:US
Practice Address - Phone:813-963-3348
Practice Address - Fax:813-963-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH1566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380576000Medicaid
FL89287Medicare PIN
FL380576000Medicaid