Provider Demographics
NPI:1093121287
Name:HOWELL, KEVIN L (PA-C)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:HOWELL
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-416-1082
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:3305 SW 34TH CIRCLE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6617
Practice Address - Country:US
Practice Address - Phone:352-732-3110
Practice Address - Fax:352-732-0228
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2024-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9108000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012634000Medicaid