Healthcare Provider Details

I. General information

NPI: 1720798036
Provider Name (Legal Business Name): KORTNEY PLOSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 W LAUREL ST STE 212
TAMPA FL
33607-1726
US

IV. Provider business mailing address

5402 W LAUREL ST STE 212
TAMPA FL
33607-1726
US

V. Phone/Fax

Practice location:
  • Phone: 813-455-1278
  • Fax:
Mailing address:
  • Phone: 813-455-1278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: