Provider Demographics
NPI:1659774735
Name:WELLCARE HEALTH PLANS OF KENTUCKY, INC.
Entity Type:Organization
Organization Name:WELLCARE HEALTH PLANS OF KENTUCKY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:813-206-6251
Mailing Address - Street 1:8735 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1143
Mailing Address - Country:US
Mailing Address - Phone:813-206-6251
Mailing Address - Fax:813-283-3313
Practice Address - Street 1:8735 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1143
Practice Address - Country:US
Practice Address - Phone:813-206-6251
Practice Address - Fax:813-283-3313
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLCARE HEALTH PLANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization