JACK PETER KOTLARZ (NPI# 1922090646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922090646 |
| Entity Type | Individual |
| Full Name | JACK PETER KOTLARZ |
| Credential | MD |
| Practice Address |
6100 North Davis Hwy Pensacola FL 32504-6950 |
| Practice Telephone | 8504712377 |
| Practice Fax Number | 8504719975 |
| Mailing Telephone | 8504712377 |
| Mailing Fax Number | 8504719975 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2011-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME62757 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | MEDICAID ALA | 009900475 | 01 |
| FL | UHC MCR RR | 040016528 | 01 |
| FL | AETNA | 4314144 | 01 |
| FL | BCBS OF FLORIDA | 42544 | 01 |
| FL | CIGNA PPO | 7618346003 | 01 |
| FL | 253548300 | 05 | |
| AL | BCBS OF ALA | 590 51780 | 01 |
| Street Address |
6100 NORTH DAVIS HWY |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-6950 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528338522 | Paul E Pearson | Specialist | 6400 N Davis Hwy, Suite 2, Pensacola, FL 32504-6903 | 2012-01-06 |
| 1932403409 | Staci Ann Jagoe | Specialist | 455 Shiloh Dr, Pensacola, FL 32503-7713 | 2010-12-27 |
| 1154640308 | Cristen Miller | Specialist | 4470 Spanish Trl, 97, Pensacola, FL 32504-4903 | 2010-05-27 |
| 1437482023 | Daniel Paul Hobgood Iv | Specialist | 4317 Spanish Trl, Pensacola, FL 32504-4942 | 2009-09-14 |
| 1336384783 | Sean Mathew Weiser | Specialist | 744 E Burgess Rd, Suite A105, Pensacola, FL 32504-6227 | 2008-12-12 |
| 1841470895 | Still Waters Medical Spa | Specialist | 20 N Tarragona St, Pensacola, FL 32502-6063 | 2007-11-07 |
| 1306032420 | Janice Leigh Nicholson | Specialist | 4438 Omaha Dr, Pensacola, FL 32507-7746 | 2007-09-21 |
| 1396938247 | Harry James Beecham IIi | Specialist | 5153 N 9th Ave Ste 305, Pensacola, FL 32504-5719 | 2007-08-23 |
| 1174713531 | Kotlarz Ent and Facial Plastic Surgery | Specialist | 6100 N Davis Hwy, Pensacola, FL 32504-6950 | 2007-07-31 |
| 1205036886 | East-west Medical & Rehabilitation Associates Pa | Specialist | 236 W. Garden St, Ste 1, Pensacola, FL 32501 | 2007-07-20 |
| Find all providers in PENSACOLA | ||||
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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.