MEDICARE: DR. KRISTIN G LITTEN BURNITZ PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY6409	FL

General Provider Information

NPI Number	:	1306020763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN G LITTEN BURNITZ PSY.D.

Provider Business Mailing Address
First Line	:	950 N KROME AVE STE 407
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-4443
Country	:	US
Telephone Number	:	305-245-0017
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 N KROME AVE STE 407
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-4443
Country	:	US
Telephone Number	:	305-245-0017
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	01/22/2009

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