Individual
MRS. KATHLEEN H KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, PT, ATC
Contact information
Practice address
14813 N DALE MABRY HWY, TAMPA, FL 33618-2027
(813) 964-5982
Mailing address
14813 N DALE MABRY HWY, TAMPA, FL 33618-2027
(813) 964-5982
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004445
CT
2251X0800X
Orthopedic Physical Therapist
Primary
PT30755
FL
2255A2300X
Athletic Trainer
000201
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08000445CT07
BLUE CROSS BLUE SHIELD
CT
01
—
2307725
AETNA PROVIDER ID
CT
01
—
2V4086
PHS HEALTHNET PROVIDER ID
CT
01
—
6404276
UHC
CT
01
—
P00063062
RR MEDICARE
CT
01
—
P3254653
OXFORD PROVIDER ID
CT
Enumeration date
01/11/2007
Last updated
12/31/2015
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