Provider Demographics
NPI:1689767303
Name:PEDIATRIC PARTNERS OF ZEPHYRHILLS, P.A.
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS OF ZEPHYRHILLS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-782-6064
Mailing Address - Street 1:PO BOX 2266
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33539-2266
Mailing Address - Country:US
Mailing Address - Phone:813-782-6064
Mailing Address - Fax:813-782-0984
Practice Address - Street 1:6748 GALL BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542
Practice Address - Country:US
Practice Address - Phone:813-782-6064
Practice Address - Fax:813-782-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE513OtherAVMED GROUP ID#
FL45447OtherBCBS GROUP ID #
FLV0014001OtherCITRUS MEDICAID GROUP ID#