Individual provider Active NPI

Theresa Dolores Kritzman, CNA231468/HHA/BLS

  • Attendant Care Provider
  • Tavares, FL
National Provider Identifier
1417631763
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
License
CNA231468 Issued in FL
Practice address
1302 Park Ave
Tavares, FL 32778-2352
Phone
(352) 702-5024
NPI assigned
Jun 14, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X CNA231468 FL Primary

Addresses

Primary practice location

1302 Park Ave
Tavares, FL 32778-2352

Mailing address

1302 Park Ave
Tavares, FL 32778-2352
Phone (352) 702-5024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CNA231468FLMDAttendant Care Provider

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1417631763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 PARK AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327782352",
            "telephone_number": "352-702-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 PARK AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327782352",
            "telephone_number": "352-702-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRITZMAN",
        "first_name": "THERESA",
        "middle_name": "DOLORES",
        "credential": "CNA231468/HHA/BLS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "FL",
            "license": "CNA231468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.