Healthcare Provider Details

I. General information

NPI: 1972083046
Provider Name (Legal Business Name): KRISTINE SLIMAK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 SW 16TH AVE
GAINESVILLE FL
32608-1158
US

IV. Provider business mailing address

9822 SW 80TH WAY
GAINESVILLE FL
32608-7209
US

V. Phone/Fax

Practice location:
  • Phone: 352-627-5077
  • Fax: 352-334-1521
Mailing address:
  • Phone: 352-284-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberARNP9219686
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9219686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: