Provider Demographics
NPI:1841345105
Name:TOTH, KRISTEN M (LMT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:TOTH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14563 NW 22ND PL
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2023
Mailing Address - Country:US
Mailing Address - Phone:352-871-0134
Mailing Address - Fax:
Practice Address - Street 1:2631 NW 41ST ST
Practice Address - Street 2:SUITE E4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7470
Practice Address - Country:US
Practice Address - Phone:352-871-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA40029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2489OtherBCBS PROVIDER #