Healthcare Provider Details

I. General information

NPI: 1992240105
Provider Name (Legal Business Name): JAMES KUO PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2016
Last Update Date: 12/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 W DR MARTIN LUTHER KING JR BLVD STE 500
TAMPA FL
33607-6205
US

IV. Provider business mailing address

1153 ABBOT AVE
SAN GABRIEL CA
91776-2903
US

V. Phone/Fax

Practice location:
  • Phone: 813-673-8275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT291113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: