Individual
DR. KRISTIE LYNN TADDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
6021 142ND AVE N, CLEARWATER, FL 33760-2822
(727) 796-6900
Mailing address
233 OSCEOLA AVE, ORMOND BEACH, FL 32176-6638
(386) 672-6424
(386) 672-5251
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
5901002145
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3265
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340608300
—
FL
01
—
5901002145
PODIATRIC MEDICINE AND SURGERY
MI
01
—
PO3265
PODIATRIC LICENSE
FL
Enumeration date
07/27/2006
Last updated
05/21/2024
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