Provider Demographics
NPI:1427759828
Name:PAINTER, CHRISTEN
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:PAINTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 CONTOURA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1706
Mailing Address - Country:US
Mailing Address - Phone:407-732-6926
Mailing Address - Fax:
Practice Address - Street 1:925 WILLISTON PARK PT # PF
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2114
Practice Address - Country:US
Practice Address - Phone:407-732-6926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA27059208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation