Provider Demographics
NPI:1053701359
Name:LUIS E. KORTRIGHT M.D.
Entity type:Organization
Organization Name:LUIS E. KORTRIGHT M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:KORTRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-871-5200
Mailing Address - Street 1:4600 N HABANA AVE
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7112
Mailing Address - Country:US
Mailing Address - Phone:813-871-5200
Mailing Address - Fax:813-871-2423
Practice Address - Street 1:4600 N HABANA AVE
Practice Address - Street 2:SUITE # 6
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7112
Practice Address - Country:US
Practice Address - Phone:813-871-5200
Practice Address - Fax:813-871-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50767207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty