Provider Demographics
NPI:1487064754
Name:CRISTANCHO, MARIA MERCEDES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:CRISTANCHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N FEDERAL HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1011
Mailing Address - Country:US
Mailing Address - Phone:954-934-9856
Mailing Address - Fax:954-934-9464
Practice Address - Street 1:1800 N FEDERAL HWY STE 105
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1011
Practice Address - Country:US
Practice Address - Phone:954-934-9856
Practice Address - Fax:954-934-9464
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138997208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine