Healthcare Provider Details

I. General information

NPI: 1538501937
Provider Name (Legal Business Name): VAKA KRISTIN SIGURJONSDOTTIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12TH AVE FL 1
MIAMI FL
33136-1005
US

IV. Provider business mailing address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-0201
  • Fax: 305-585-7025
Mailing address:
  • Phone: 860-545-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME151475
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberME151475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: