Healthcare Provider Details

I. General information

NPI: 1164639647
Provider Name (Legal Business Name): CHRISTINA ELIZABETH HEJJA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CORAL HILLS DR STE 305
CORAL SPRINGS FL
33065-4138
US

IV. Provider business mailing address

3100 CORAL HILLS DR STE 305
CORAL SPRINGS FL
33065-4138
US

V. Phone/Fax

Practice location:
  • Phone: 954-575-8056
  • Fax: 954-575-2563
Mailing address:
  • Phone: 954-575-8056
  • Fax: 954-575-2563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9102117
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: