Provider Demographics
NPI:1518340140
Name:RELIHAN, CRISTINA (PA-C)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:RELIHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD STE 450
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6002
Practice Address - Country:US
Practice Address - Phone:813-875-8453
Practice Address - Fax:813-377-1390
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108702363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIJ821ZMedicare PIN