Provider Demographics
NPI:1346238052
Name:POZO KADERMAN, CRISTINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:POZO KADERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2106
Mailing Address - Country:US
Mailing Address - Phone:305-243-4129
Mailing Address - Fax:305-243-5233
Practice Address - Street 1:1121 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2106
Practice Address - Country:US
Practice Address - Phone:305-243-4129
Practice Address - Fax:305-243-5233
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4950103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59691ZMedicare ID - Type Unspecified
FLS04644Medicare UPIN