Provider Demographics
NPI:1114549565
Name:TOMLINSON, KARA L
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:TOMLINSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 SW MAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-6684
Mailing Address - Country:US
Mailing Address - Phone:386-752-7900
Mailing Address - Fax:386-752-4472
Practice Address - Street 1:1270 SW MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6684
Practice Address - Country:US
Practice Address - Phone:386-752-7900
Practice Address - Fax:386-752-4472
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5232416164W00000X
FLAPRN11036816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No164W00000XNursing Service ProvidersLicensed Practical Nurse