Provider Demographics
NPI:1699880013
Name:NODAR-MILLER, CRISTINA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:NODAR-MILLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 SW 87TH AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2500
Mailing Address - Country:US
Mailing Address - Phone:786-897-7593
Mailing Address - Fax:305-220-2093
Practice Address - Street 1:6401 SW 87TH AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2500
Practice Address - Country:US
Practice Address - Phone:786-897-7593
Practice Address - Fax:305-220-2093
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5992103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
54512AMedicare ID - Type Unspecified