Provider Demographics
NPI:1700353984
Name:IRIZARRY-LEON, CRISTINA M (MSN, CRNA)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:M
Last Name:IRIZARRY-LEON
Suffix:
Gender:F
Credentials:MSN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12101 S GARDENS DR APT 106
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-5905
Mailing Address - Country:US
Mailing Address - Phone:787-243-2076
Mailing Address - Fax:
Practice Address - Street 1:12101 S GARDENS DR APT 106
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-5905
Practice Address - Country:US
Practice Address - Phone:787-243-2076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL114286367500000X
PR114286367500000X
FL9500025163W00000X
FLAPRN11000611367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse