Provider Demographics
NPI:1184712960
Name:BEST, KATHLEEN CK (PA-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CK
Last Name:BEST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-9000
Mailing Address - Fax:352-392-8413
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-9000
Practice Address - Fax:352-392-8413
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0001621363AS0400X
FLPA1621363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290127700Medicaid
FL7913200OtherPA. CERTIFICATE NUMBER
FL140004911OtherRR MC PROVIDER NUMBER
FLPA0001621OtherPA.LICENSE NUMBER
FL7913200OtherPA. CERTIFICATE NUMBER
FLPA0001621OtherPA.LICENSE NUMBER