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MS. KRISTINE ROBERTA ILGENFRITZ PAC
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1144382623
Individual Registrant:MS. KRISTINE ROBERTA ILGENFRITZ PAC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
109 TIMBERLACHEN CIR LAKE MARY, FL 32746-3395 US
Tel: 407-333-9877 Fax: 407-333-9881
Tel: 407-333-9877 Fax: 407-333-9881
Contact information for business:
109 TIMBERLACHEN CIR LAKE MARY, FL 32746-3395 US
Tel: 407-333-9877 Fax: 407-333-9881
Tel: 407-333-9877 Fax: 407-333-9881
Registration Information:
NPI: 1144382623
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | FL | PA9100962 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
