Provider Demographics
NPI:1194968594
Name:KAZIL, JENNA LINDSEY CAPORASO (MD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LINDSEY CAPORASO
Last Name:KAZIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LINDSEY
Other - Last Name:CAPORASO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 MANATEE AVE W
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8604
Mailing Address - Country:US
Mailing Address - Phone:727-787-4379
Mailing Address - Fax:
Practice Address - Street 1:701 MANATEE AVE W
Practice Address - Street 2:SUITE 105
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8604
Practice Address - Country:US
Practice Address - Phone:727-787-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery