Active NPI
Cristina Park, M.D.
- Psychiatry Physician
- Coconut Grove, FL
National Provider Identifier
1669664462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME106235
- Practice address
- 3390 Mary St
Ste 116
Coconut Grove, FL 33133-5255 - Phone
- (786) 278-7800
- Fax
- (786) 409-4727
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME106235 | FL | Primary |
Addresses
Primary practice location
3390 Mary St
Ste 116
Coconut Grove, FL 33133-5255
Mailing address
3390 Mary St Ste 116
Coconut Grove, FL 33133-5255
Phone (786) 278-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1669664462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3390 MARY ST STE 116",
"city": "COCONUT GROVE",
"state": "FL",
"postal_code": "331335255",
"telephone_number": "786-278-7800",
"fax_number": "786-409-4727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3390 MARY ST",
"address_2": "STE 116",
"city": "COCONUT GROVE",
"state": "FL",
"postal_code": "331335255",
"telephone_number": "786-278-7800",
"fax_number": "786-409-4727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CRISTINA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME106235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coconut Grove, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.