Provider Demographics
NPI:1558128843
Name:FLORES, CHRISTINA RODRIGUEZ (RDN, CDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:RODRIGUEZ
Last Name:FLORES
Suffix:
Gender:F
Credentials:RDN, CDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 BIENVILLE BLVD APT 131
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3126
Mailing Address - Country:US
Mailing Address - Phone:718-650-1764
Mailing Address - Fax:
Practice Address - Street 1:2501 BIENVILLE BLVD APT 131
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3126
Practice Address - Country:US
Practice Address - Phone:718-650-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01044601133V00000X
MSD2199133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered