Provider Demographics
NPI:1205221207
Name:DOU, CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:DOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 LUCIEN WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7003
Mailing Address - Country:US
Mailing Address - Phone:407-875-0028
Mailing Address - Fax:
Practice Address - Street 1:2201 LUCIEN WAY STE 100
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7003
Practice Address - Country:US
Practice Address - Phone:407-875-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135721207QH0002X
FLME136721207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine