Provider Demographics
NPI:1184962136
Name:RIVERA RUIZ, CRISTINA M (PHD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:M
Last Name:RIVERA RUIZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CRISTINA
Other - Middle Name:M
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PH D
Mailing Address - Street 1:4861 TRAMANTO LN
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-2513
Mailing Address - Country:US
Mailing Address - Phone:787-975-2277
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 34TH AVE STE 701
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8443
Practice Address - Country:US
Practice Address - Phone:877-779-2429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
FLPY11973103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist