Provider Demographics
NPI:1306115910
Name:RICHARDS, KRISTIN ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANN
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6651 OLD WINTER GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-1221
Mailing Address - Country:US
Mailing Address - Phone:407-293-2941
Mailing Address - Fax:
Practice Address - Street 1:6651 OLD WINTER GARDEN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-1221
Practice Address - Country:US
Practice Address - Phone:407-293-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist