Provider Demographics
NPI:1609180785
Name:ROBERTS, KRISTEN KAY (DPT)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:KAY
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6999
Mailing Address - Country:US
Mailing Address - Phone:954-986-2299
Mailing Address - Fax:954-986-0339
Practice Address - Street 1:3325 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6999
Practice Address - Country:US
Practice Address - Phone:954-986-2299
Practice Address - Fax:954-986-0339
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist