Individual
MISS FLOR DE MARIA CRISOLOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
209 NE 95TH ST, SUITE 9, MIAMI SHORES, FL 33138-2745
(305) 751-5454
(305) 751-1977
Mailing address
209 NE 95TH ST, SUITE 9, MIAMI SHORES, FL 33138-2745
(305) 751-5454
(305) 751-1977
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2114402
FL
363AM0700X
Medical Physician Assistant
PA9100393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290990100
—
FL
Enumeration date
01/23/2006
Last updated
06/23/2009
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