Provider Demographics
NPI:1851379036
Name:RADBILL, KEVIN A (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:RADBILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21406
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-1406
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:727-828-0723
Practice Address - Street 1:1400 S ORLANDO AVE
Practice Address - Street 2:STE 204
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5543
Practice Address - Country:US
Practice Address - Phone:407-647-4008
Practice Address - Fax:407-647-3207
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00862313OtherRAILROAD MEDICARE
FL293013OtherAVMED
37604OtherBCBS
FL293013OtherAVMED
I06805Medicare UPIN
FL37604ZMedicare ID - Type Unspecified