Provider Demographics
NPI:1730658428
Name:VARGA SEAMAN, KRISTIN (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:VARGA SEAMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 SE MONTEREY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4512
Mailing Address - Country:US
Mailing Address - Phone:772-288-2400
Mailing Address - Fax:772-419-0143
Practice Address - Street 1:9401 SW DISCOVERY WAY STE 202
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2381
Practice Address - Country:US
Practice Address - Phone:772-288-2400
Practice Address - Fax:772-419-0143
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist