Individual
KIRSTIN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
455 WEST WARREN AVE, 200, LONGWOOD, FL 32750-4038
(407) 260-0551
(407) 265-9590
Mailing address
455 W WARREN AVE STE 200, LONGWOOD, FL 32750-4038
(407) 260-0551
(407) 265-9590
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18513
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT18513
STATE OF FLORIDA DEPT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
06/08/2017
Last updated
07/21/2022
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