MEDICARE: DR. CRISTINA M VIGO-CORDOVEZ AU.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AY1346	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467499202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRISTINA M VIGO-CORDOVEZ AU.D

Provider Business Mailing Address
First Line	:	3431 SW 107TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3632
Country	:	US
Telephone Number	:	305-552-8822
Fax Number	:	305-551-7220

Provider Business Practice Location Address
First Line	:	3431 SW 107TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3632
Country	:	US
Telephone Number	:	305-552-8822
Fax Number	:	305-557-7220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	12/01/2020

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