Healthcare Provider Details

I. General information

NPI: 1548503691
Provider Name (Legal Business Name): ISABEL CRISTINA PRIETO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEDICAL PARK DR STE 500
TAMPA FL
33613-6600
US

IV. Provider business mailing address

3000 MEDICAL PARK DR STE 500
TAMPA FL
33613-6600
US

V. Phone/Fax

Practice location:
  • Phone: 813-615-7117
  • Fax: 813-615-8350
Mailing address:
  • Phone: 813-615-7117
  • Fax: 813-615-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME144939
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME144939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: