Healthcare Provider Details

I. General information

NPI: 1750304945
Provider Name (Legal Business Name): EDWARD CHRISTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2381 MASON AVE STE 100
DAYTONA BEACH FL
32117-5161
US

IV. Provider business mailing address

13 SENTRY OAK PL
PALM COAST FL
32137-8057
US

V. Phone/Fax

Practice location:
  • Phone: 386-225-2000
  • Fax:
Mailing address:
  • Phone: 810-280-0862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberEC071230
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME166404
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME166404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: