Provider Demographics
NPI:1508676537
Name:ONGAY VARGAS, CRISTABELL M (PA)
Entity type:Individual
Prefix:
First Name:CRISTABELL
Middle Name:M
Last Name:ONGAY VARGAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CRISTABELL
Other - Middle Name:M
Other - Last Name:JIMENEZ ONGAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:426 PRESERVE POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-9342
Mailing Address - Country:US
Mailing Address - Phone:407-818-3188
Mailing Address - Fax:
Practice Address - Street 1:426 PRESERVE POINTE BLVD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-9342
Practice Address - Country:US
Practice Address - Phone:407-818-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002335-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant