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General NPI Number Information
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NPI Number | 1497059273
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Entity Type | Individual
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Provider Name | ASAYA ANN CRISOSTOMO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2101 PARK CENTER DR STE 130
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City | ORLANDO
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State | FL
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Zip | 32835-7611
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Country | US
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Telephone | 407-298-6950
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Fax | 407-578-2354
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Provider Business Mailing Address
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Address Line | PO BOX 860912
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0912
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Country | US
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Telephone | 507-284-2511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 54208
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9114297
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15360
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9114297
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License Number State | FL
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