Provider Demographics
NPI:1235297797
Name:RAAB, KRISTINE ANN (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANN
Last Name:RAAB
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96000 OVERSEAS HWY
Mailing Address - Street 2:U8
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2131
Mailing Address - Country:US
Mailing Address - Phone:650-274-8349
Mailing Address - Fax:
Practice Address - Street 1:100210 OVERSEAS HIGHWAY
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037
Practice Address - Country:US
Practice Address - Phone:305-453-1088
Practice Address - Fax:305-453-1183
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026440-1225100000X
FLPT 29119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist