Provider Demographics
NPI:1225155021
Name:VOEGTLI, KRYSTYNA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTYNA
Middle Name:RENEE
Last Name:VOEGTLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRYSTYNA
Other - Middle Name:RENEE
Other - Last Name:FLUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12479 TELECOM DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0913
Mailing Address - Country:US
Mailing Address - Phone:813-769-7252
Mailing Address - Fax:
Practice Address - Street 1:3100 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4613
Practice Address - Country:US
Practice Address - Phone:813-769-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114913207P00000X
MO2008029856207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008315600Medicaid
FLHL072YOtherMEDICARE