KOTLARZ ENT AND FACIAL PLASTIC SURGERY (NPI# 1174713531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174713531 |
| Entity Type | Organization |
| Organization Name | KOTLARZ ENT AND FACIAL PLASTIC SURGERY |
| Practice Address |
6100 N Davis Hwy Pensacola FL 32504-6950 |
| Practice Telephone | 8504712377 |
| Practice Fax Number | 8504719975 |
| Mailing Telephone | 8504712377 |
| Mailing Fax Number | 8504719975 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | MR. JACK P KOTLARZ (PHYSICIAN) |
| Authorized Official Telephone | 8504712377 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME62757 | FL | Other Service Providers |
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE GROUP | K3071 | 01 |
| Street Address |
6100 N DAVIS HWY |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-6950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891161154 | Advanced Surgery Center LLC | Clinic/Center | 6100 N Davis Hwy, Pensacola, FL 32504-6950 | 2015-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317479 | Ent Associates Pa | Otolaryngology | 3390 Tamiami Trl Ste 201-202, Port Charlotte, FL 33952-8157 | 2019-10-13 |
| 1679878615 | Herbert Kean | Otolaryngology | 799 Crandon Blvd, Apt 1407, Key Biscayne, FL 33149 | 2011-01-24 |
| 1881784841 | Scott Jeffery Trimas | Otolaryngology | 1361 13th Ave South, Ste 125, Jacksonville, FL 32250 | 2006-10-13 |
| 1225032006 | Rangaswamy Asokan | Otolaryngology | 2651 Sw 32nd Pl, Ocala, FL 34471 | 2005-06-09 |
| 1851818686 | Accent Physician Specialists, P.a. | Otolaryngology | 3304 Sw 34th Cir Ste 103, Ocala, FL 34474-3357 | 2017-08-23 |
| 1720527021 | Randall P Weyrich Md LLC | Otolaryngology | 6602 Seabird Way, Apollo Beach, FL 33572-3003 | 2017-02-20 |
| 1326416413 | Edward H. Farrior, Md, Pa | Otolaryngology | 2908 W Azeele St, Tampa, FL 33609-3110 | 2015-09-08 |
| 1528442332 | Genesiscare of Florida LLC | Otolaryngology | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2015-07-13 |
| 1225448921 | The Palm Beach Center for Facial Plastic & Laser Surgery, P.a. | Otolaryngology | 4495 Military Trl Ste 202, Jupiter, FL 33458 | 2014-05-02 |
| 1801219944 | Edward J. Gross, M.d., P.l. | Otolaryngology | 1035 Primera Blvd, Lake Mary, FL 32746-2193 | 2014-01-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.