Provider Demographics
NPI:1386956274
Name:DOROTHY T CHRISTMAN MD PL
Entity type:Organization
Organization Name:DOROTHY T CHRISTMAN MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHRISTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-785-1998
Mailing Address - Street 1:2114 SEVEN SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3908
Mailing Address - Country:US
Mailing Address - Phone:727-375-2719
Mailing Address - Fax:727-372-1901
Practice Address - Street 1:2114 SEVEN SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-3908
Practice Address - Country:US
Practice Address - Phone:727-375-2719
Practice Address - Fax:727-372-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82646261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262062600Medicaid
FL262062600Medicaid
H45961Medicare UPIN