Provider Demographics
NPI:1467638908
Name:SIOPES, KRISTA B
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:B
Last Name:SIOPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 SPRING VILLAS PT
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5258
Mailing Address - Country:US
Mailing Address - Phone:407-629-9455
Mailing Address - Fax:407-629-9138
Practice Address - Street 1:1016 SPRING VILLAS PT
Practice Address - Street 2:SUITE 1030
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5258
Practice Address - Country:US
Practice Address - Phone:407-629-9455
Practice Address - Fax:407-629-9138
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12862225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT 12862OtherOT LICENSE