Provider Demographics
NPI:1235900192
Name:BANES, KRIZIA ARRIOLA (ITDS)
Entity Type:Individual
Prefix:
First Name:KRIZIA
Middle Name:ARRIOLA
Last Name:BANES
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17835 EVERLONG DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8271
Mailing Address - Country:US
Mailing Address - Phone:949-228-3892
Mailing Address - Fax:
Practice Address - Street 1:17835 EVERLONG DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8271
Practice Address - Country:US
Practice Address - Phone:949-228-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist