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General NPI Number Information
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NPI Number | 1982073425
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Entity Type | Individual
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Provider Name | MARIBEL CRIDER DOM, AP
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Gender | Female
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 2431 ALOMA AVE SUITE 107
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City | WINTER PARK
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State | FL
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Zip | 32792-2541
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Country | US
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Telephone | 321-696-1581
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Fax |
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Provider Business Mailing Address
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Address Line | 2876 SPRING HEATHER PL
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City | OVIEDO
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State | FL
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Zip | 32766-6621
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Country | US
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Telephone | 321-696-1581
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 3665
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License Number State | FL
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