Basic Information
| Provider Information | |||||||||
| NPI: | 1386385862 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | KRISTINA | ||||||||
| MiddleName: | MEGAN MICHELLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20900 BISCAYNE BLVD STE 8218TH | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056923392 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20900 BISCAYNE BLVD STE 8218TH | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056923392 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2022 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | FL | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.