Healthcare Provider Details

I. General information

NPI: 1568501880
Provider Name (Legal Business Name): KATHRYN HASKEW TOSONE ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 71ST ST
MIAMI FL
33150-3894
US

IV. Provider business mailing address

347 SW 191ST TER
PEMBROKE PINES FL
33029-5448
US

V. Phone/Fax

Practice location:
  • Phone: 305-836-0991
  • Fax: 305-691-4955
Mailing address:
  • Phone: 954-450-4763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL685
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: