Provider Demographics
NPI:1588219687
Name:OEHLER, KRISTI SHEA
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:SHEA
Last Name:OEHLER
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 1:3864 GRANDPINE WAY APT 106
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4388
Mailing Address - Country:US
Mailing Address - Phone:407-414-8309
Mailing Address - Fax:
Practice Address - Street 1:145 MIDDLE ST STE 1101
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3594
Practice Address - Country:US
Practice Address - Phone:407-323-6955
Practice Address - Fax:855-306-2974
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16329224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant