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1821298779

NPI Code Detail

MEDICARE: CHRISTOPHER G RESTREPO MD

MEDICARE: CHRISTOPHER G RESTREPO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD.30192	AL
2	208000000X	Pediatrics Physician	MD.30192	AL
3	208000000X	Pediatrics Physician	LL29779	SC
4	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	ME115551	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Z10935	OTHER	AL	VIVA HEALTH
3	511-06202	OTHER	AL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1821298779	OTHER	AL	TRICARE SOUTH
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	511-06612	OTHER	AL	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821298779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER G RESTREPO MD

Provider Business Mailing Address
First Line	:	2502 W SAINT ISABEL ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6318
Country	:	US
Telephone Number	:	813-874-5707
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 W SAINT ISABEL ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6318
Country	:	US
Telephone Number	:	813-874-5707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	06/02/2023

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Directions to “ CHRISTOPHER G RESTREPO MD” Practice Location

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