Provider Demographics
NPI:1396897120
Name:WEINER, KRISTI E (PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:E
Last Name:WEINER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9901 EMERALD LINKS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2551
Mailing Address - Country:US
Mailing Address - Phone:813-914-9000
Mailing Address - Fax:813-984-6907
Practice Address - Street 1:13357 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1161
Practice Address - Country:US
Practice Address - Phone:813-914-9000
Practice Address - Fax:813-984-6907
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73101OtherBLUE CROSS BLUE SHIELD
FL73101XMedicare ID - Type Unspecified