MEDICARE: CRISTINA RIOS FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	F08200651	FL
2	363L00000X	Nurse Practitioner	F08200651	FL

General Provider Information

NPI Number	:	1629733126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA RIOS FNP-C

Provider Business Mailing Address
First Line	:	618 GENIUS DR
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-5137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 TURKEY LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4216
Country	:	US
Telephone Number	:	407-351-9696
Fax Number	:

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

Provider Enumeration Date	:	11/01/2021
Last Update Date	:	08/17/2022

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