Healthcare Provider Details

I. General information

NPI: 1205728474
Provider Name (Legal Business Name): KRISTINA NEREIDA SANADI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 HEALING WAY STE 112
WESLEY CHAPEL FL
33543-5453
US

IV. Provider business mailing address

6110 RAIN BRIAR CT
TEMPLE TERRACE FL
33617-1370
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5226
  • Fax: 813-929-5332
Mailing address:
  • Phone: 813-454-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11040960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: