Provider Demographics
NPI:1174259709
Name:ROBERTS, CRISTINA ELENA (FNP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ELENA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:ELENA
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2781 S OAKLAND FOREST DR APT 303
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-7547
Mailing Address - Country:US
Mailing Address - Phone:770-374-7622
Mailing Address - Fax:
Practice Address - Street 1:2781 S OAKLAND FOREST DR APT 303
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-7547
Practice Address - Country:US
Practice Address - Phone:770-374-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily