MEDICARE: CRISTINA SANDOVAL

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	152W00000X	Optometrist	OPC5350	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	:	1730615410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA SANDOVAL

Provider Business Mailing Address
First Line	:	8889 W COLONIAL DR
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-6951
Country	:	US
Telephone Number	:	407-298-4631
Fax Number	:	407-298-3311

Provider Business Practice Location Address
First Line	:	8889 W COLONIAL DR
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-6951
Country	:	US
Telephone Number	:	407-298-4631
Fax Number	:	407-298-3311

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

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	02/10/2026

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Directions to “ CRISTINA SANDOVAL ” Practice Location

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