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NPI Code Detail

MEDICARE: DEBBIE KIAG P.T.

MEDICARE: DEBBIE KIAG P.T.
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT 18109OTHERFLLICENSE#

General Provider Information

NPI Number : 1366551954
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBBIE KIAG P.T.
Provider Business Mailing Address
First Line : 14596 110TH TER
Second Line :
City : LARGO
State : FL
Zip : 33774-4444
Country : US
Telephone Number : 777-517-0670
Fax Number :
Provider Business Practice Location Address
First Line : 5535 PARK ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33709-6309
Country : US
Telephone Number : 727-209-0579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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Directions to “ DEBBIE KIAG P.T.” Practice Location

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