Healthcare Provider Details

I. General information

NPI: 1558972703
Provider Name (Legal Business Name): CHRISTOPHER EDWARD ROYSTER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 SUNRISE PLAZA DR STE 6
CLERMONT FL
34714-6202
US

IV. Provider business mailing address

1222 LAKE PIEDMONT CIR
APOPKA FL
32703-7454
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-9341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: