Provider Demographics
NPI:1346426194
Name:ORDETX, KIRSTINA E (EDD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTINA
Middle Name:E
Last Name:ORDETX
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 JACKIE LYNN CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-9280
Mailing Address - Country:US
Mailing Address - Phone:941-755-1400
Mailing Address - Fax:
Practice Address - Street 1:6215 LORRAINE RD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-6708
Practice Address - Country:US
Practice Address - Phone:941-755-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist