Healthcare Provider Details
I. General information
NPI: 1720742851
Provider Name (Legal Business Name): NATALIA LOUISE KONTUL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/25/2021
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2727 W DR MLK BLVD STE 320
TAMPA FL
33607-6055
US
IV. Provider business mailing address
2995 DREW ST
CLEARWATER FL
33759-3012
US
V. Phone/Fax
- Phone: 813-877-6748
- Fax: 813-875-0359
- Phone: 727-315-7496
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 085.008628 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 085.008628 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA9118696 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: