MEDICARE: KATHERINE MCKIEL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA9121433	FL

General Provider Information

NPI Number	:	1205781416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MCKIEL PA-C

Provider Business Mailing Address
First Line	:	1211 WHITEHOUSE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-1236
Country	:	US
Telephone Number	:	719-640-6020
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PINELLAS ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3804
Country	:	US
Telephone Number	:	727-462-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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