Healthcare Provider Details

I. General information

NPI: 1144922030
Provider Name (Legal Business Name): KAITLIN MARIE THOMPSON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JOHN F KENNEDY DR STE 100
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

805 N OLIVE AVE APT 720
WEST PALM BEACH FL
33401-3753
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-6500
  • Fax: 833-464-2037
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4634
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: