Provider Demographics
NPI:1174384705
Name:HERNANDEZ, KRISTINYA ORR
Entity type:Individual
Prefix:
First Name:KRISTINYA
Middle Name:ORR
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 WHITEWILLOW DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5486
Mailing Address - Country:US
Mailing Address - Phone:813-766-1720
Mailing Address - Fax:
Practice Address - Street 1:6272 ABBOTT STATION DR STE D
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-4877
Practice Address - Country:US
Practice Address - Phone:813-766-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1737103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist