Provider Demographics
NPI:1982073425
Name:CRIDER, MARIBEL (DOM, AP)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:CRIDER
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:MARIBEL
Other - Middle Name:
Other - Last Name:QUINONES AVILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CLS
Mailing Address - Street 1:2876 SPRING HEATHER PL
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-6621
Mailing Address - Country:US
Mailing Address - Phone:321-696-1581
Mailing Address - Fax:
Practice Address - Street 1:2431 ALOMA AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:321-696-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3665171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist