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NPI Code Detail

MEDICARE: HIND KETTANI M.D.

MEDICARE: HIND KETTANI M.D.
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
12084E0001XEpilepsy PhysicianME137027FL
22084N0400XNeurology PhysicianME137027FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME137027OTHERFLME LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982832952
Entity Type Code : Individual
Provider Name (Legal Business Name) : HIND KETTANI M.D.
Provider Business Mailing Address
First Line : 13067 N TELECOM PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0926
Country : US
Telephone Number : 813-779-6303
Fax Number : 786-868-0012
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 : 06/29/2009
Last Update Date : 03/18/2024

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Directions to “ HIND KETTANI M.D.” Practice Location

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