Provider Demographics
NPI:1750831327
Name:HYOTALA, KARI MICHELLE (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:MICHELLE
Last Name:HYOTALA
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 W DR MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4040
Mailing Address - Fax:813-554-8480
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD FL 1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4619
Practice Address - Fax:813-554-8557
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX909546363LA2100X
FLAPRN11005888363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107209100Medicaid