Healthcare Provider Details

I. General information

NPI: 1710893144
Provider Name (Legal Business Name): CRISTINA ISABEL VARGAS-MARRERO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MIDLAND PARK RD
NORTH CHARLESTON SC
29406-4546
US

IV. Provider business mailing address

3229 W MONTAGUE AVE UNIT 5309
NORTH CHARLESTON SC
29418-7957
US

V. Phone/Fax

Practice location:
  • Phone: 843-574-2183
  • Fax:
Mailing address:
  • Phone: 787-599-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9774
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: