Provider Demographics
NPI:1316953391
Name:BISHOP, KEVIN R (ARNP)
Entity type:Individual
Prefix:MS
First Name:KEVIN
Middle Name:R
Last Name:BISHOP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:R KAPUTA
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:800-749-7424
Practice Address - Fax:352-265-0281
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP730522363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S65609Medicare UPIN
E1397XMedicare PIN