Healthcare Provider Details

I. General information

NPI: 1265034896
Provider Name (Legal Business Name): KRISTIN LITTEN BURNITZ PSYD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N KROME AVE STE 470
HOMESTEAD FL
33030-4400
US

IV. Provider business mailing address

950 N KROME AVE STE 470
HOMESTEAD FL
33030-4400
US

V. Phone/Fax

Practice location:
  • Phone: 305-245-0017
  • Fax:
Mailing address:
  • Phone: 305-245-0017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTIN LITTEN BURNITZ
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 305-245-0017