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NPI Code Detail

MEDICARE: DR. KATHERINE DOLORES STANDLEY DO

MEDICARE: DR. KATHERINE DOLORES STANDLEY DO
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
12084N0400XNeurology PhysicianOS11907FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154556181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE DOLORES STANDLEY DO
Provider Business Mailing Address
First Line : 13067 N TELECOM PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0926
Country : US
Telephone Number : 813-773-6658
Fax Number :
Provider Business Practice Location Address
First Line : 3000 MEDICAL PARK DR STE 510
Second Line :
City : TAMPA
State : FL
Zip : 33613-6602
Country : US
Telephone Number : 813-615-7725
Fax Number : 813-615-7082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2009
Last Update Date : 06/17/2024

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Directions to “ DR. KATHERINE DOLORES STANDLEY DO” Practice Location

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