MS. MARY KATHLEEN FLACH QUISENBERRY PA-C NPI 1497822563

NPI Information

NPI: 1497822563
Provider Name: MS. MARY KATHLEEN FLACH QUISENBERRY, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
119 OAKFIELD DR
BRANDON, FL
ZIP 33511
Phone: (813) 571-5100
Get Directions

MS. Mary Kathleen Flach Quisenberry, PA-C is a medical physician assistant in Brandon, FL. MS. Mary Kathleen Flach Quisenberry, PA-C NPI is 1497822563. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

119 OAKFIELD DR
BRANDON, FL
ZIP 33511-779
Phone: (813) 571-5100
Fax: (813) 653-7025

The NPI 1497822563 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 2/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA9103942	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000410200	MEDICAID	FLORIDA
2	Y02CL	OTHER	FLORIDA	BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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