Provider Demographics
NPI:1770643355
Name:HRYCUNA, KATHY (PA)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:HRYCUNA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 SW 32ND PL STE 400
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7166
Mailing Address - Country:US
Mailing Address - Phone:352-369-0101
Mailing Address - Fax:352-873-0101
Practice Address - Street 1:2685 SW 32ND PL STE 400
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7166
Practice Address - Country:US
Practice Address - Phone:352-369-0101
Practice Address - Fax:352-873-0101
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2906363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical