Healthcare Provider Details

I. General information

NPI: 1639289986
Provider Name (Legal Business Name): CHRISTINA M. PRIETO AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N KNOWLES AVE
WINTER PARK FL
32789-3851
US

IV. Provider business mailing address

527 S OSCEOLA AVE #3
ORLANDO FL
32801-3943
US

V. Phone/Fax

Practice location:
  • Phone: 407-234-6454
  • Fax: 407-428-6165
Mailing address:
  • Phone: 407-234-6454
  • Fax: 407-428-6165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: