Individual
PARICHART KOONKITTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
Mailing address
12479 TELECOM DR, TEMPLE TERRACE, FL 33637-0913
(813) 972-4199
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME125284
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U67LF
BCBSF
—
Enumeration date
03/23/2012
Last updated
03/16/2016
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