Individual
KRISTIN E CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4950 CALYPSO CAY WAY, KISSIMMEE, FL 34746-5520
(872) 231-3162
Mailing address
1317 EDGEWATER DR # 2945, ORLANDO, FL 32804-6350
(407) 538-5921
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
079600
MI
208100000X
Physical Medicine & Rehabilitation Physician
52430-20
WI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME137481
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101476800
—
FL
01
—
250E26047
BLUE CROSS BLUE SHIELD MI
MI
05
—
4396267
—
MI
01
—
LELVIKRI
MERCYCARE INSURANCE
WI
01
—
P00772226CD3624
RR MEDICARE
WI
Enumeration date
10/03/2005
Last updated
01/06/2026
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