Provider Demographics
NPI:1689911661
Name:BUCHBACH, KRISTEN P (PT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:P
Last Name:BUCHBACH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:PARISI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8828 WARWICK SHORE XING
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8028
Mailing Address - Country:US
Mailing Address - Phone:540-550-1416
Mailing Address - Fax:
Practice Address - Street 1:8828 WARWICK SHORE XING
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8028
Practice Address - Country:US
Practice Address - Phone:540-550-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206694225100000X
FL34298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ42190AMedicare PIN