Provider Demographics
NPI:1699160093
Name:CHRISTOPHER CONTANCE MD
Entity type:Organization
Organization Name:CHRISTOPHER CONTANCE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-639-5655
Mailing Address - Street 1:PO BOX 495641
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5641
Mailing Address - Country:US
Mailing Address - Phone:941-639-5665
Mailing Address - Fax:941-639-6673
Practice Address - Street 1:2525 HARBOR BLVD
Practice Address - Street 2:310
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5317
Practice Address - Country:US
Practice Address - Phone:941-639-6556
Practice Address - Fax:941-639-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59168208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty