Provider Demographics
NPI:1679843106
Name:JOSE, KRISTINA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:JOSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 N ORANGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7613
Mailing Address - Country:US
Mailing Address - Phone:407-896-9660
Mailing Address - Fax:407-896-9661
Practice Address - Street 1:3000 N ORANGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7613
Practice Address - Country:US
Practice Address - Phone:407-896-9660
Practice Address - Fax:407-896-9661
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2014-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME112827207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease