Healthcare Provider Details

I. General information

NPI: 1407542871
Provider Name (Legal Business Name): CRISTINA LITCHFIELD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA LITCHFIELD-MULERO

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 STATE HIGHWAY 100 E STE 107
PALM COAST FL
32164-2796
US

IV. Provider business mailing address

5650 STATE HIGHWAY 100 E STE 107
PALM COAST FL
32164-2796
US

V. Phone/Fax

Practice location:
  • Phone: 386-586-1760
  • Fax:
Mailing address:
  • Phone: 386-586-1760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS23904
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: