Provider Demographics
NPI:1285885541
Name:WILES, KEVIN PATRICK (HSC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:PATRICK
Last Name:WILES
Suffix:
Gender:M
Credentials:HSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 FAIRCHILD DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3507
Mailing Address - Country:US
Mailing Address - Phone:727-536-1391
Mailing Address - Fax:
Practice Address - Street 1:15300 FAIRCHILD DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3507
Practice Address - Country:US
Practice Address - Phone:727-536-1391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other