Individual
DR. KRISTEN JOHNSON OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-8363
(813) 745-3830
Mailing address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-8363
(813) 745-3830
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20640
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00785270
M'CARE RR
—
Enumeration date
06/15/2009
Last updated
07/08/2014
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