Healthcare Provider Details

I. General information

NPI: 1467759423
Provider Name (Legal Business Name): CRISTINAT M TRAVIESO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2011
Last Update Date: 02/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR SUITE 303
MIAMI FL
33176-2144
US

IV. Provider business mailing address

8950 N KENDALL DR SUITE 303
MIAMI FL
33176-2144
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4070
  • Fax:
Mailing address:
  • Phone: 305-595-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9199038
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: