Individual
DR. KATINA MELANIE FOSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 S PINELLAS AVE STE J, TARPON SPRINGS, FL 34689-1951
(727) 943-3640
(727) 942-9745
Mailing address
6919 N DALE MABRY HWY STE 250, TAMPA, FL 33614-3860
(813) 935-4210
(813) 932-7940
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME119622
FL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
ME119622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014189400
—
FL
01
—
P01524561
RR MEDICARE
FL
Enumeration date
04/02/2007
Last updated
07/29/2020
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