Provider Demographics
NPI:1598072159
Name:TEIBEL, KRISTA A (AP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:A
Last Name:TEIBEL
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6831 SW 44TH ST
Mailing Address - Street 2:#313
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4793
Mailing Address - Country:US
Mailing Address - Phone:305-542-4075
Mailing Address - Fax:
Practice Address - Street 1:3402 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5564
Practice Address - Country:US
Practice Address - Phone:305-542-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2887171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist