Provider Demographics
NPI:1578965265
Name:KRUMHOLZ FARINAS, BRETT E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRETT
Middle Name:E
Last Name:KRUMHOLZ FARINAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRETT
Other - Middle Name:
Other - Last Name:KRUMHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:4321 N MACDILL AVE STE 407
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6396
Practice Address - Country:US
Practice Address - Phone:813-554-8690
Practice Address - Fax:813-605-6068
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014678600Medicaid