Individual
DAVID WILLIAM KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6321 54TH AVE N, ST PETERSBURG, FL 33709-1703
(727) 545-9902
(727) 457-0264
Mailing address
6321 54TH AVE N, ST PETERSBURG, FL 33709-1703
(727) 545-9902
(727) 457-0264
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT18524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144315391
FACILITY NPI NUMBER
FL
01
—
GG9
BCBS FACILITY PROVIDER NO
FL
Enumeration date
06/11/2007
Last updated
07/09/2007
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