Provider Demographics
NPI:1811668049
Name:RIVERA PADILLA, CRISTOPHER LUIS (DC)
Entity type:Individual
Prefix:DR
First Name:CRISTOPHER
Middle Name:LUIS
Last Name:RIVERA PADILLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3288 CANOE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-9115
Mailing Address - Country:US
Mailing Address - Phone:407-593-0990
Mailing Address - Fax:
Practice Address - Street 1:3288 CANOE CREEK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-9115
Practice Address - Country:US
Practice Address - Phone:407-593-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor