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NPI Code Detail

MEDICARE: CHRISTINA MARIE CLEMENTE

MEDICARE: CHRISTINA MARIE CLEMENTE
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1386586170
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MARIE CLEMENTE
Provider Business Mailing Address
First Line : 4222 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-1628
Country : US
Telephone Number : 863-456-7148
Fax Number :
Provider Business Practice Location Address
First Line : 4222 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-1628
Country : US
Telephone Number : 863-456-7148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ CHRISTINA MARIE CLEMENTE ” Practice Location

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