Edith Lorraine Kavouklis, RN, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11026304 Issued in FL

Practice address

4010 W State St
Tampa, FL 33609-1264

Phone

(813) 758-0305

NPI assigned

Nov 16, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Edith Keating-Kavouklis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neos Aesthetics

  • Clinic/Center
  • Tampa, FL
  • NPI 1073294906
  NPD Authorized official
• Philotemo Health and Wellness

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1639850563
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1700399433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-758-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-758-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVOUKLIS",
        "first_name": "EDITH",
        "middle_name": "LORRAINE",
        "credential": "RN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9465920",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11026304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDITH",
            "last_name": "KEATING-KAVOUKLIS",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Supreet Kaur, MD
• Akhil Kaushik, MD
• John W Kauzlarich, D.O
• Brendan Kavanaugh, D.O.
• Reena Jiju Kavilaveettil, MD
• Lazarus Nick Kavouklis, D.M.D.
• Nicholas Michael Kavouklis, DMD
• Nick L Kavouklis, D.D.S.
• Vibha Kawatra, M.D.
• Alex Kawliche, LMHC

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.