Provider Demographics
NPI:1407738099
Name:MARMANILLO, CRISTINA VICTORIA
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:VICTORIA
Last Name:MARMANILLO
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 1:14734 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6123
Mailing Address - Country:US
Mailing Address - Phone:954-257-1650
Mailing Address - Fax:
Practice Address - Street 1:6941 SW 196TH AVE STE 29
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33332-1609
Practice Address - Country:US
Practice Address - Phone:954-999-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI80922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant