MEDICARE: CHRISTINE LORRAINE KIRLEW

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
1	207R00000X	Internal Medicine Physician	073720	GA
2	207R00000X	Internal Medicine Physician	ME157226	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851657399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE LORRAINE KIRLEW

Provider Business Mailing Address
First Line	:	5089 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1326
Country	:	US
Telephone Number	:	727-375-7929
Fax Number	:	813-635-2634

Provider Business Practice Location Address
First Line	:	5089 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1326
Country	:	US
Telephone Number	:	727-375-7929
Fax Number	:	813-635-2634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	10/06/2022

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Directions to “ CHRISTINE LORRAINE KIRLEW ” Practice Location

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