Provider Demographics
NPI:1467499202
Name:VIGO-CORDOVEZ, CRISTINA M (AUD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:M
Last Name:VIGO-CORDOVEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3632
Mailing Address - Country:US
Mailing Address - Phone:305-552-8822
Mailing Address - Fax:305-551-7220
Practice Address - Street 1:3431 SW 107TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3632
Practice Address - Country:US
Practice Address - Phone:305-552-8822
Practice Address - Fax:305-557-7220
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1346231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600478400Medicaid
FL0116950OtherGHI
FLU5276YMedicare PIN