Provider Demographics
NPI:1073816955
Name:RONACHER, CHRISTOPH (MS)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPH
Middle Name:
Last Name:RONACHER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12618
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-2618
Mailing Address - Country:US
Mailing Address - Phone:305-767-1924
Mailing Address - Fax:
Practice Address - Street 1:1040 BISCAYNE BLVD
Practice Address - Street 2:APT. 3606
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1706
Practice Address - Country:US
Practice Address - Phone:786-942-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-10-7874103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017516200Medicaid