Provider Demographics
NPI:1417409541
Name:RUBIO, CRISTINA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ALEJANDRA
Last Name:RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10490 SW 12TH TER APT 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3836
Mailing Address - Country:US
Mailing Address - Phone:786-762-1166
Mailing Address - Fax:
Practice Address - Street 1:1414 NW 107TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2742
Practice Address - Country:US
Practice Address - Phone:786-505-4449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician