Healthcare Provider Details

I. General information

NPI: 1548805492
Provider Name (Legal Business Name): MATTHEW BRIAN KAZEE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 6TH ST S
ST PETERSBURG FL
33701-4891
US

IV. Provider business mailing address

1456 PLATEAU RD
CLEARWATER FL
33755-1255
US

V. Phone/Fax

Practice location:
  • Phone: 727-823-1234
  • Fax:
Mailing address:
  • Phone: 813-523-5568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9258018
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11005490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: