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General NPI Number Information
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NPI Number | 1972487163
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Entity Type | Individual
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Provider Name | KRISTI OLIVER
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Gender | Female
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 808 DUNLAWTON AVE STE 4
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City | PORT ORANGE
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State | FL
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Zip | 32127-9284
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Country | US
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Telephone | 720-955-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 STATE ROAD 44 UNIT 9201
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-8276
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Country | US
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Telephone | 720-955-9656
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI8124
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License Number State | FL
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