Provider Demographics
NPI:1275275729
Name:DELGIORNO, KRISTAL DAWN (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTAL
Middle Name:DAWN
Last Name:DELGIORNO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1345
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32756-1345
Mailing Address - Country:US
Mailing Address - Phone:352-742-4444
Mailing Address - Fax:352-742-4446
Practice Address - Street 1:1858 MAYO DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4320
Practice Address - Country:US
Practice Address - Phone:352-742-4444
Practice Address - Fax:352-383-3534
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily