Healthcare Provider Details

I. General information

NPI: 1891244265
Provider Name (Legal Business Name): CHRISTINA CIMARUSTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 VANDERBILT BEACH RD
NAPLES FL
34109-2653
US

IV. Provider business mailing address

1684 MORNING SUN LN
NAPLES FL
34119-3317
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 806-474-7448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9436135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: