Provider Demographics
NPI:1356331383
Name:CARDOZO, MARIA CRISTINA (MS)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CRISTINA
Last Name:CARDOZO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 N RIVERSIDE DR
Mailing Address - Street 2:UNIT 604
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1236
Mailing Address - Country:US
Mailing Address - Phone:954-781-0029
Mailing Address - Fax:954-343-0412
Practice Address - Street 1:2639 N RIVERSIDE DR APT 604
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1246
Practice Address - Country:US
Practice Address - Phone:954-781-0029
Practice Address - Fax:954-343-0412
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL768450900Medicaid