MEDICARE: DR. KRISTINA MARIE MCLEAN MD

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	207V00000X	Obstetrics & Gynecology Physician	2021-03021	NC
2	207V00000X	Obstetrics & Gynecology Physician	ME0081277	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669426656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINA MARIE MCLEAN MD

Provider Business Mailing Address
First Line	:	3190 CITRUS TOWER BLVD STE B
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6886
Country	:	US
Telephone Number	:	352-432-1414
Fax Number	:	352-432-1479

Provider Business Practice Location Address
First Line	:	3190 CITRUS TOWER BLVD STE B
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6886
Country	:	US
Telephone Number	:	352-432-1414
Fax Number	:	352-432-1479

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	01/12/2026

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