MEDICARE: CRISTINA SOTOMAYOR RODRIGUEZ APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1048975	TX

General Provider Information

NPI Number	:	1528891330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA SOTOMAYOR RODRIGUEZ APRN, CNP

Provider Business Mailing Address
First Line	:	7601 CHURCHILL WAY APT 1015
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-1935
Country	:	US
Telephone Number	:	954-913-8402
Fax Number	:

Provider Business Practice Location Address
First Line	:	12201 MERIT DR STE 180
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-3124
Country	:	US
Telephone Number	:	972-385-9700
Fax Number	:	972-385-9790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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