Provider Demographics
NPI:1760604581
Name:ROUSSILLON, KRISTIN C (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:C
Last Name:ROUSSILLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:943 S BENEVA RD STE 306
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2499
Mailing Address - Country:US
Mailing Address - Phone:941-955-1108
Mailing Address - Fax:941-954-4440
Practice Address - Street 1:5951 CATTLERIDGE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-9801
Practice Address - Country:US
Practice Address - Phone:941-379-1850
Practice Address - Fax:941-379-1855
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2025-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME116245207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology