Individual
KARA JEAN KOBYLKA RUSSELL
Active
Individual
KARA JEAN KOBYLKA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9105628
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9105628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004172500
—
FL
01
—
PA9105628
MEDICAL LICENSE
FL
Enumeration date
10/18/2010
Last updated
11/15/2016
Update your record
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