MEDICARE: CRISTINA MIGUEL

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	390200000X	Student in an Organized Health Care Education/Training Program	43416	FL

General Provider Information

NPI Number	:	1477313955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA MIGUEL

Provider Business Mailing Address
First Line	:	9390 SW 63RD CT
Second Line	:
City	:	PINECREST
State	:	FL
Zip	:	33156-1815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6420 SW 62ND AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3302
Country	:	US
Telephone Number	:	305-665-4411
Fax Number	:

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

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	03/20/2024

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Directions to “ CRISTINA MIGUEL ” Practice Location

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