Provider Demographics
NPI:1750533683
Name:SOSA-GONZALEZ, KRISTINA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:SOSA-GONZALEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3903 NORTHDALE BLVD
Mailing Address - Street 2:STE 111W
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1864
Mailing Address - Country:US
Mailing Address - Phone:813-418-7350
Mailing Address - Fax:813-265-2504
Practice Address - Street 1:9415 SUNSET DR
Practice Address - Street 2:STE 111
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5427
Practice Address - Country:US
Practice Address - Phone:786-507-8278
Practice Address - Fax:786-409-2692
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
225X00000X
FLOT13338225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist