Individual
MR. JACK JOSEPH CRISTIANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1625 SE 3RD AVE STE 300, FORT LAUDERDALE, FL 33316-2521
(954) 355-4665
(954) 355-4881
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 355-4665
(954) 355-4881
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9116364
FL
Other
Enumeration date
01/05/2021
Last updated
04/03/2024
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