Provider Demographics
NPI:1164838306
Name:PRICE, CHRISTY
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RRT
Mailing Address - Street 1:2625 BONTERRA BLVD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-3809
Mailing Address - Country:US
Mailing Address - Phone:863-286-2619
Mailing Address - Fax:
Practice Address - Street 1:2625 BONTERRA BLVD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3809
Practice Address - Country:US
Practice Address - Phone:863-286-2619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT12300227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered