Provider Demographics
NPI:1376825414
Name:DEVITO, CRISTINA M
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:M
Last Name:DEVITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:MARIE
Other - Last Name:DEVITO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSOT
Mailing Address - Street 1:1033 ALMERIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 ALMERIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5822
Practice Address - Country:US
Practice Address - Phone:305-461-4702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist