Provider Demographics
NPI:1740329358
Name:REID, KARI (OTR)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 FLORESTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1719
Mailing Address - Country:US
Mailing Address - Phone:813-264-4263
Mailing Address - Fax:813-264-4264
Practice Address - Street 1:1921 FLORESTA VIEW DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1719
Practice Address - Country:US
Practice Address - Phone:813-264-4263
Practice Address - Fax:813-264-4264
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11256174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist