Provider Demographics
NPI:1912556283
Name:RODRIGUEZ CARTAGENA, CHRISTIAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:RODRIGUEZ CARTAGENA
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RODEL CV STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4859
Mailing Address - Country:US
Mailing Address - Phone:321-841-5111
Mailing Address - Fax:407-302-7038
Practice Address - Street 1:725 RODEL CV STE 200
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4859
Practice Address - Country:US
Practice Address - Phone:321-841-5111
Practice Address - Fax:407-302-7038
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003977363LF0000X
FLAPRN11003977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily