Provider Demographics
NPI:1699172403
Name:VIGOA, CRISTINA RODRIGUEZ (ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:RODRIGUEZ
Last Name:VIGOA
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 SW 96TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1273
Mailing Address - Country:US
Mailing Address - Phone:786-467-3430
Mailing Address - Fax:786-533-9695
Practice Address - Street 1:15955 SW 96TH ST STE 401
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1273
Practice Address - Country:US
Practice Address - Phone:786-467-3430
Practice Address - Fax:786-533-9695
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer