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General NPI Number Information
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NPI Number | 1154530707
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Entity Type | Organization
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Legal Business Name | KURT B. REPKE, M.D., P.A.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 646 VIRGINIA ST 5TH FLOOR
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City | DUNEDIN
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State | FL
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Zip | 34698-6612
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Country | US
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Telephone | 727-736-7873
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Fax | 727-736-7905
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Provider Business Mailing Address
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Address Line | 1965 COVE LN
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City | CLEARWATER
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State | FL
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Zip | 33764-6426
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Country | US
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Telephone | 727-736-7873
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Fax | 727-736-7905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KURT BRYAN REPKE
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Credential | M.D.
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Telephone | 727-736-7873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME0079899
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License Number State | FL
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