Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jack Joseph Cristiano Jr., PA-C

Individual provider Surgical Physician Assistant · NPI 1356939409

Mr. Jack Joseph Cristiano Jr., PA-C is a Physician Assistant in Fort Lauderdale, Florida. Qualified in 2022, 4 years ago. Practices with Cheyenne Regional Physicians Group LLC, a 103-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1625 SE 3rd Ave Ste 300
Fort Lauderdale, FL 33316-2521
Phone: (954) 355-4665
Fax: (954) 355-4881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 9116364 (FL)

Record details

NPI number1356939409
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2021
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cheyenne Regional Physicians Group Llc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fort Lauderdale