Individual
KATHRYN M WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C, MPAS
Contact information
Practice address
603 7TH ST S STE 500, ST PETERSBURG, FL 33701-4734
(727) 893-6254
(727) 553-7158
Mailing address
603 7TH ST S STE 500, ST PETERSBURG, FL 33701-4734
(727) 893-6254
(727) 553-7158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015249
NY
363A00000X
Physician Assistant
PA113210
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9113210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107387800
—
FL
Enumeration date
11/08/2011
Last updated
04/12/2023
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