Basic Information
| Provider Information | |||||||||
| NPI: | 1851657399 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIRLEW | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | LORRAINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5089 LITTLE RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346551326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273757929 | ||||||||
| FaxNumber: | 8136352634 | ||||||||
| Practice Location | |||||||||
| Address1: | 5089 LITTLE RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346551326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273757929 | ||||||||
| FaxNumber: | 8136352634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2012 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 073720 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME157226 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.