Individual
MRS. ASAYA ANN CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2101 PARK CENTER DR STE 130, ORLANDO, FL 32835-7611
(407) 298-6950
(407) 578-2354
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15360
MN
363A00000X
Physician Assistant
54208
CA
363A00000X
Physician Assistant
PA9114297
FL
363AM0700X
Medical Physician Assistant
PA9114297
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009560400
—
FL
01
—
1225266
WELLCARE
FL
01
—
5569125
CIGNA
FL
01
—
7513951
AETNA
FL
01
—
P01214789
RAILROAD MCR
FL
01
—
P1019777
FREEDOM
FL
01
—
P958302
OPTIMUM
FL
01
—
Y0J2W
BCBS OF FL
FL
Enumeration date
01/07/2011
Last updated
10/09/2025
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