Provider Demographics
NPI:1700026671
Name:KREIDER, CONSUELO (OTR/L)
Entity type:Individual
Prefix:
First Name:CONSUELO
Middle Name:
Last Name:KREIDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CONSUELO
Other - Middle Name:M
Other - Last Name:KREIDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, OTR/L
Mailing Address - Street 1:2210 NW 40TH TER STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3589
Mailing Address - Country:US
Mailing Address - Phone:352-538-9881
Mailing Address - Fax:
Practice Address - Street 1:2210 NW 40TH TER STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3589
Practice Address - Country:US
Practice Address - Phone:352-538-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2451225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist