Provider Demographics
NPI:1972896496
Name:KIFFER-HADDEN, MARIA CHRISTINA (LMT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:KIFFER-HADDEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 W NEWBERRY RD STE D9
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2177
Mailing Address - Country:US
Mailing Address - Phone:352-378-1412
Mailing Address - Fax:
Practice Address - Street 1:5200 W NEWBERRY RD STE D9
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2177
Practice Address - Country:US
Practice Address - Phone:352-378-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62759225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist