Provider Demographics
NPI:1154655413
Name:KITTERMAN, CECILIA MARIA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:MARIA
Last Name:KITTERMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-6314
Mailing Address - Country:US
Mailing Address - Phone:727-940-5413
Mailing Address - Fax:
Practice Address - Street 1:4105 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1731
Practice Address - Country:US
Practice Address - Phone:727-372-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24606225100000X
MA17416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist