Provider Demographics
NPI:1285163360
Name:CRISTINO, SANDRA MARIA
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MARIA
Last Name:CRISTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 WASHIGTON STREET APT.V312
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7761
Mailing Address - Country:US
Mailing Address - Phone:954-889-4559
Mailing Address - Fax:
Practice Address - Street 1:5300 WASHIGTON STREET APT.V312
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-7761
Practice Address - Country:US
Practice Address - Phone:954-889-4559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17-313246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty