Individual
EDITH LORRAINE KAVOUKLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APRN
Contact information
Practice address
4010 W STATE ST, TAMPA, FL 33609-1264
(813) 758-0305
Mailing address
4010 W STATE ST, TAMPA, FL 33609-1264
(813) 758-0305
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9465920
FL
363L00000X
Nurse Practitioner
Primary
APRN11026304
FL
Other
Enumeration date
11/16/2017
Last updated
05/30/2023
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