Idowu, Kristen
Idowu, Kristen is an sole proprietor health care provider with primary practice located at 12236 Tavares Ridge Ln , Tavares FL 32778-4460. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Phlebotomy, which is considered as her primary health care specialty. Idowu, Kristen can be contacted via phone (352) 636-2821.Contact Information
Primary practice address
12236 Tavares Ridge Ln
Tavares FL 32778-4460
Phone: (352) 636-2821
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Phlebotomy | 246RP1900X |
Profile Details
| NPI number | 1043079072 |
|---|---|
| LBN Legal business name | Idowu, Kristen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2024 |
| Last updated | Mar 13th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043079072 | NPPES |
| Florida | MEDICAID | 10D2292576 | |
| Florida | MEDICAID | 922686490 |
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