Provider Demographics
NPI:1386688950
Name:HAMPER, CHRIS (PA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:HAMPER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 CORAL WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3213
Mailing Address - Country:US
Mailing Address - Phone:305-461-6060
Mailing Address - Fax:305-461-5911
Practice Address - Street 1:9030 KIMBERLY BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2823
Practice Address - Country:US
Practice Address - Phone:561-488-2300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0003304363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA0003304OtherMEDICAL LICENSE