Individual
DR. KRISTINE VALLRUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
630 S OWL DR, SARASOTA, FL 34236-1908
(123) 456-7890
Mailing address
630 S OWL DR, SARASOTA, FL 34236-1908
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036-106413
IL
2084P0800X
Psychiatry Physician
107971
MN
2084P0800X
Psychiatry Physician
Primary
ME97660
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002743500
—
FL
Enumeration date
12/11/2006
Last updated
03/22/2016
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