Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | SRNA | FL |
NPI | 1013597657 |
---|---|
Provider Name | Kristi Creel |
First Address | Orlando, FL 32812-7992 |
Second Address | Orlando, FL 32812-7992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2021 |
Last Update Date | 08/04/2021 |