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NPI Code Detail

MEDICARE: KATHLEEN LOUISE PAVEL PA

MEDICARE: KATHLEEN LOUISE PAVEL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA9110987FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LP952OTHERFLMCR FL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3592-40194OTHERALBCBS AL
4P4ZXNOTHERFLBCBS FL
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033263207
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN LOUISE PAVEL PA
Provider Business Mailing Address
First Line : 2315 W JACKSON ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32505-7552
Country : US
Telephone Number : 850-436-4630
Fax Number : 850-436-2095
Provider Business Practice Location Address
First Line : 5855 CREEK STATION DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-8626
Country : US
Telephone Number : 850-435-4352
Fax Number : 850-497-6195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 10/15/2019

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1447428503 — LAURIE Q SEIGH CNM
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Directions to “ KATHLEEN LOUISE PAVEL PA” Practice Location

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