Most Relevant Information
Provider Data
| NPI Number: | 1003405077 |
| Provider Name: | KAYLA MARIE KOLANKO PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA9113956 |
Most Important Dates
| Enumeration Date: | 01/14/2021 |
| Last Updated: | 01/20/2021 |
Provider Practice Location
16025 MUIRFIELD DR
ODESSA
FL
335562861
Practice Location Phone/Fax
| Phone: | 3043741049 |
| Fax: |
Provider Mailing Location
PO BOX 22
ODESSA
FL
335560022
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |