Provider Demographics
NPI:1588897755
Name:NEVAREZ DE JESUS, CRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:NEVAREZ DE JESUS
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 1:64 CALLE CEREZO
Mailing Address - Street 2:URB FINCA ELENA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-743-1985
Mailing Address - Fax:787-744-6276
Practice Address - Street 1:1699 CALLE PARANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3143
Practice Address - Country:US
Practice Address - Phone:787-751-2395
Practice Address - Fax:787-751-2493
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12451 I207R00000X
PR18428207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine