Christine Rene Carrillo, RN, RNFA, CNOR

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

RN2055572 Issued in FL

Practice address

1311 Garden St
Titusville, FL 32796-3312

Phone

(321) 268-0720

Fax

(321) 383-7596

NPI assigned

Mar 26, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carrillo Surgical Associates LLC

  • Surgery Physician
  • Titusville, FL
  • NPI 1104871102
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301097600000",
    "number": "1114226362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963312",
            "telephone_number": "321-268-0720",
            "fax_number": "321-383-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963312",
            "telephone_number": "321-268-0720",
            "fax_number": "321-383-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "CHRISTINE",
        "middle_name": "RENE",
        "credential": "RN, RNFA, CNOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2011-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "RN2055572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA NURSING LICENSE",
            "identifier": "RN2055572",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmona Pathology Associates PA
• Pedro A Carmona, MD
• Felicia Carnahan
• Mary Elizabeth Carr-de Vries, IMH
• Carrillo Surgical Associates LLC
• James Edward Carter
• Jan Cary
• Joseph R Casale, RPT
• Stephen Castle II, PTA
• Kevin Cauble, PTA

• Registered Nurse First Assistant in Titusville, FL
• Providers in Titusville, FL by specialty
• Registered Nurse First Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.