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General NPI Number Information
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NPI Number | 1396921680
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Entity Type | Individual
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Provider Name | KRISTY A BAUTISTA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 3305 S. ORANGE AVENUE
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City | ORLANDO
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State | FL
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Zip | 32806
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Country | US
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Telephone | 407-599-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 3948 LAKESIDE RESERVE LN
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City | ORLANDO
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State | FL
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Zip | 32810-2811
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Country | US
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Telephone | 407-376-0463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT13670
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License Number State | FL
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