Provider Demographics
NPI:1942217609
Name:BABIAK, CRISTINA M (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:M
Last Name:BABIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-6495
Mailing Address - Country:US
Mailing Address - Phone:941-474-6593
Mailing Address - Fax:
Practice Address - Street 1:1790 7TH ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-6495
Practice Address - Country:US
Practice Address - Phone:941-474-6593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080144368OtherRR MEDICARE
FL47458Medicare ID - Type Unspecified
D55067Medicare UPIN