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Individual

ROMAN KAZACHOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8447
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9358798
FL

Other

Enumeration date
07/08/2013
Last updated
07/09/2013
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