Provider Demographics
NPI:1699972646
Name:DR JOHN P CHRISTENSEN P A
Entity type:Organization
Organization Name:DR JOHN P CHRISTENSEN P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-655-2225
Mailing Address - Street 1:5768 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4343
Mailing Address - Country:US
Mailing Address - Phone:561-689-4700
Mailing Address - Fax:561-689-9909
Practice Address - Street 1:5768 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4343
Practice Address - Country:US
Practice Address - Phone:561-689-4700
Practice Address - Fax:561-689-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9898BMedicare ID - Type Unspecified