Healthcare Provider Details

I. General information

NPI: 1982152682
Provider Name (Legal Business Name): KAITLYN OSTROSKI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W CLEVELAND ST SUITE 220
TAMPA FL
33606-1812
US

IV. Provider business mailing address

1501 W CLEVELAND ST SUITE 220
TAMPA FL
33606-1812
US

V. Phone/Fax

Practice location:
  • Phone: 813-805-8105
  • Fax:
Mailing address:
  • Phone: 813-805-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT31806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: