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NPI Code Detail

MEDICARE: KRISTIE DILORENZO

MEDICARE: KRISTIE DILORENZO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor29029FL

General Provider Information

NPI Number : 1528902590
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIE DILORENZO
Provider Business Mailing Address
First Line : 224 SAND DOLLAR RD
Second Line :
City : INDIALANTIC
State : FL
Zip : 32903-2112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 S HARBOR CITY BLVD STE 401
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-1389
Country : US
Telephone Number : 321-259-1662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “ KRISTIE DILORENZO ” Practice Location

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