Provider Demographics
NPI:1538196548
Name:KOEBBE, CHRISTOPHER J (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:KOEBBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 49TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2100
Mailing Address - Country:US
Mailing Address - Phone:727-605-1770
Mailing Address - Fax:727-605-1080
Practice Address - Street 1:5800 49TH ST N STE 201
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2100
Practice Address - Country:US
Practice Address - Phone:727-605-1770
Practice Address - Fax:727-605-1080
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123561207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4YHN4OtherBCBS
TX200297404OtherCSHCN
TX8AL632OtherBCBS
TX200297403Medicaid
TX200297401Medicaid