Provider Demographics
NPI:1427007830
Name:TOOMRE, KRISTA A (MD)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:A
Last Name:TOOMRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 S BENEVA RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2476
Mailing Address - Country:US
Mailing Address - Phone:941-953-5213
Mailing Address - Fax:941-953-3087
Practice Address - Street 1:2750 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3573
Practice Address - Country:US
Practice Address - Phone:303-440-3102
Practice Address - Fax:303-440-3175
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G16149Medicare UPIN
FL44311ZMedicare PIN