Provider Demographics
NPI:1063200012
Name:KRIPAROS, CASSANDRA LYNN
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:KRIPAROS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 MAGUIRE BLVD APT 5309
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-7208
Mailing Address - Country:US
Mailing Address - Phone:757-771-4718
Mailing Address - Fax:
Practice Address - Street 1:6917 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-7002
Practice Address - Country:US
Practice Address - Phone:321-348-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT26124225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist