Healthcare Provider Details

I. General information

NPI: 1346115268
Provider Name (Legal Business Name): KRISTEN SCHWEITZER LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 BREEZEWAY ST STE 100
YULEE FL
32097-3651
US

IV. Provider business mailing address

12408 CASHEROS COVE DR S
JACKSONVILLE FL
32225-5124
US

V. Phone/Fax

Practice location:
  • Phone: 904-427-8300
  • Fax: 904-427-8316
Mailing address:
  • Phone: 321-368-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL7461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: