Provider Demographics
NPI:1316147663
Name:CHRISS & ASSOCIATES M D P A
Entity type:Organization
Organization Name:CHRISS & ASSOCIATES M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHULTZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-629-4305
Mailing Address - Street 1:1925 MIZELL AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4155
Mailing Address - Country:US
Mailing Address - Phone:407-629-6646
Mailing Address - Fax:407-740-5089
Practice Address - Street 1:1925 MIZELL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4155
Practice Address - Country:US
Practice Address - Phone:407-629-6646
Practice Address - Fax:407-740-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
180020382Medicare PIN
0474310001Medicare NSC
FL98773Medicare PIN