Provider Demographics
NPI:1508188202
Name:ALBINO, MATER KRISTIE ALCUBILLA
Entity Type:Individual
Prefix:MRS
First Name:MATER KRISTIE
Middle Name:ALCUBILLA
Last Name:ALBINO
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 1:4526 BROOK HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4643
Mailing Address - Country:US
Mailing Address - Phone:407-927-5646
Mailing Address - Fax:
Practice Address - Street 1:4526 BROOK HOLLOW CIR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4643
Practice Address - Country:US
Practice Address - Phone:407-927-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 4922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist