Individual
DR. KRIS-ANN SHANIQUE HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
790 CONCOURSE PKWY S STE 200, MAITLAND, FL 32751-6114
(407) 767-6411
Mailing address
790 CONCOURSE PKWY S, MAITLAND, FL 32751-6114
(407) 767-6411
(407) 767-8160
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
146759
FL
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
146759
FL
Other
Enumeration date
03/31/2015
Last updated
11/30/2023
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