Provider Demographics
NPI:1134779770
Name:SZAKAL BRIDGES, KATHERINE (PA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SZAKAL BRIDGES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:E
Other - Last Name:SZAKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4464
Mailing Address - Country:US
Mailing Address - Phone:850-233-3376
Mailing Address - Fax:850-522-8354
Practice Address - Street 1:1474 MARKET ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-1768
Practice Address - Country:US
Practice Address - Phone:850-233-3376
Practice Address - Fax:850-522-8354
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9430363A00000X
FLPA9116055363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant