Healthcare Provider Details

I. General information

NPI: 1790864759
Provider Name (Legal Business Name): CRISTINA MARY ZERETZKE-BIEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRISTINA MARY ZERETZKE MD

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-0186
US

IV. Provider business mailing address

1600 SW ARCHER RD
GAINESVILLE FL
32610-0186
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-5911
  • Fax: 352-265-5606
Mailing address:
  • Phone: 352-265-5911
  • Fax: 352-265-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number511386
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number203610
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: