MEDICARE: KATHRYN LUCILLE KEPES MD

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
1	2085R0001X	Radiation Oncology Physician	ME0045273	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	30766	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144225244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN LUCILLE KEPES MD

Provider Business Mailing Address
First Line	:	303 N ALEXANDER ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4303
Country	:	US
Telephone Number	:	813-719-7705
Fax Number	:	813-719-7906

Provider Business Practice Location Address
First Line	:	303 N ALEXANDER ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4303
Country	:	US
Telephone Number	:	813-719-7705
Fax Number	:	813-719-7906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/30/2013

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