Provider Demographics
NPI:1104926856
Name:CHRISPHONTE, BERNARD FRANCOIS (RRT)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:FRANCOIS
Last Name:CHRISPHONTE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6862 HOULTON CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8741
Mailing Address - Country:US
Mailing Address - Phone:561-304-0598
Mailing Address - Fax:
Practice Address - Street 1:6862 HOULTON CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-8741
Practice Address - Country:US
Practice Address - Phone:561-304-0598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT67942279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8902038Medicaid