Provider Demographics
NPI:1851657399
Name:KIRLEW, CHRISTINE LORRAINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LORRAINE
Last Name:KIRLEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5089 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1326
Mailing Address - Country:US
Mailing Address - Phone:727-375-7929
Mailing Address - Fax:813-635-2634
Practice Address - Street 1:5089 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1326
Practice Address - Country:US
Practice Address - Phone:727-375-7929
Practice Address - Fax:813-635-2634
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA073720207R00000X
FLME157226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine