Healthcare Provider Details

I. General information

NPI: 1952111072
Provider Name (Legal Business Name): CRISTINA LOUISE DESIR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE STE 300
HOLLYWOOD FL
33021-5428
US

IV. Provider business mailing address

2900 CORPORATE WAY # D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-3500
  • Fax: 954-989-0454
Mailing address:
  • Phone: 954-276-5603
  • Fax: 954-985-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11036964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: