Healthcare Provider Details

I. General information

NPI: 1851702278
Provider Name (Legal Business Name): KRISTEN ELIZABETH SEDIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 S ALAFAYA TRL
ORLANDO FL
32828-8926
US

IV. Provider business mailing address

932 STETSON ST
ORLANDO FL
32804-5769
US

V. Phone/Fax

Practice location:
  • Phone: 407-384-2767
  • Fax: 321-281-4942
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ 6642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: