Kristy A Rattanavong I
Specialist/Technologist, Other in Longwood, FL. Individual provider (NPI-1).
NPI number1982103149
StatusActive
Last updated in NPPESFeb 2, 2018
Details
- NPI
- 1982103149
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kristy A Rattanavong I
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 2, 2018
- Last updated
- Feb 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246Z00000X | Specialist/Technologist, Other | – | – | Yes |
Practice location
450 Brentwood Club CvLongwood, FL 32750-3354
Phone 407-256-6786
Mailing address
450 Brentwood Club CvLongwood, FL 32750-3354
Phone 407-256-6786
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