MEDICARE: KAITLIN E HARTMANN

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	367H00000X	Anesthesiologist Assistant	1049	FL

General Provider Information

NPI Number	:	1477358836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN E HARTMANN

Provider Business Mailing Address
First Line	:	430 E TRELLIS LN
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-8700
Country	:	US
Telephone Number	:	414-322-7938
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PINELLAS ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3804
Country	:	US
Telephone Number	:	727-462-7000
Fax Number	:

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

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	03/10/2026

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