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Individual
KRYSTA JEAN DEFTY
Active
Individual
KRYSTA JEAN DEFTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007345500
—
FL
01
—
1249031
WELLCARE
FL
01
—
1720187
CIGNA
FL
01
—
398581
AVMED
FL
01
—
5296786
AETNA
FL
01
—
P01480233
RR MEDICARE
FL
01
—
P1004057
FREEDOM
FL
01
—
P951597
OPTIMUM
FL
01
—
Y0F3C
BCBS FL INDIVIDUAL PROVIDER ID #
FL
Enumeration date
10/29/2012
Last updated
12/14/2016
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