Provider Demographics
NPI:1770874141
Name:ARLETA ANNA KITLAS, M. D., PA
Entity type:Organization
Organization Name:ARLETA ANNA KITLAS, M. D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARLETA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:KITLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-792-5578
Mailing Address - Street 1:5015 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3857
Mailing Address - Country:US
Mailing Address - Phone:941-792-5578
Mailing Address - Fax:941-798-3603
Practice Address - Street 1:5015 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3857
Practice Address - Country:US
Practice Address - Phone:941-792-5578
Practice Address - Fax:941-798-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 106492207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty