Provider Demographics
NPI:1265114870
Name:FERNANDEZ, CRISTINA MARIA (OTD,OTR/L)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:OTD,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8620 SW 212TH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3385
Mailing Address - Country:US
Mailing Address - Phone:786-339-6670
Mailing Address - Fax:
Practice Address - Street 1:10700 CARIBBEAN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1224
Practice Address - Country:US
Practice Address - Phone:305-707-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24423225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist