Individual
DAVID E. KOTUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101200
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290738100
—
FL
01
—
Y0M53
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/20/2006
Last updated
10/12/2015
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