Provider Demographics
NPI:1093370421
Name:AMIERO-PEREZ, KRISTINA (LMT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:AMIERO-PEREZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-2316
Mailing Address - Country:US
Mailing Address - Phone:813-446-9108
Mailing Address - Fax:
Practice Address - Street 1:3916 OHIO AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-2316
Practice Address - Country:US
Practice Address - Phone:813-446-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist