Provider Demographics
NPI:1548411226
Name:CORSI, KRISTEN L (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:CORSI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 SUMMIT CENTRE WAY
Mailing Address - Street 2:APT 205
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5971
Mailing Address - Country:US
Mailing Address - Phone:614-946-2368
Mailing Address - Fax:
Practice Address - Street 1:1706 E SEMORAN BLVD
Practice Address - Street 2:#107
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5651
Practice Address - Country:US
Practice Address - Phone:407-880-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT012250174400000X
FLPT24533174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist