Provider Demographics
NPI:1609311968
Name:PLAZA, CRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:CRISTINE
Middle Name:
Last Name:PLAZA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-4827
Mailing Address - Country:US
Mailing Address - Phone:727-546-4700
Mailing Address - Fax:727-549-8108
Practice Address - Street 1:4655 66TH ST N
Practice Address - Street 2:
Practice Address - City:KENNETH CITY
Practice Address - State:FL
Practice Address - Zip Code:33709-4827
Practice Address - Country:US
Practice Address - Phone:727-546-4700
Practice Address - Fax:727-549-8108
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist