Provider Demographics
NPI:1013788454
Name:HUFF, KEVIN LEE (CNA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEE
Last Name:HUFF
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12610 BAYOU OAKS PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3676
Mailing Address - Country:US
Mailing Address - Phone:813-904-4539
Mailing Address - Fax:
Practice Address - Street 1:12610 BAYOU OAKS PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3676
Practice Address - Country:US
Practice Address - Phone:813-904-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL236150376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide