Healthcare Provider Details

I. General information

NPI: 1487064754
Provider Name (Legal Business Name): MARIA MERCEDES CRISTANCHO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NE 36TH ST STE 202
LIGHTHOUSE POINT FL
33064-7574
US

IV. Provider business mailing address

2100 NE 36TH ST STE 202
LIGHTHOUSE POINT FL
33064-7574
US

V. Phone/Fax

Practice location:
  • Phone: 954-934-9856
  • Fax: 954-934-9464
Mailing address:
  • Phone: 954-934-9856
  • Fax: 954-934-9464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME138997
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME138997
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: