Provider Demographics
NPI:1376556878
Name:CRISTIANO, MICHAEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CRISTIANO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 N FEDERAL HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1032
Mailing Address - Country:US
Mailing Address - Phone:954-788-9399
Mailing Address - Fax:954-905-4990
Practice Address - Street 1:1200 N FEDERAL HWY
Practice Address - Street 2:STE 200
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2813
Practice Address - Country:US
Practice Address - Phone:954-899-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6322101YP2500X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC1900X, 103TE1100X, 103TH0100X, 103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54659OtherBCBS OF FLORIDA
FL2079795OtherCIGNA BEHAVIORAL HEALTH
FL100067990001OtherAPS HEALTHCARE
FL216850OtherCOMPSYCH
FL331055922OtherHUMANA
FL337124OtherVALUE OPTIONS
FL100067990001OtherAPS HEALTHCARE
FL54659OtherBCBS OF FLORIDA
FL54659AMedicare PIN