Healthcare Provider Details

I. General information

NPI: 1922769785
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM URRUTIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 OAKRIDGE DR
FROSTPROOF FL
33843-9611
US

IV. Provider business mailing address

73 OAKRIDGE DR
FROSTPROOF FL
33843-9611
US

V. Phone/Fax

Practice location:
  • Phone: 407-334-8745
  • Fax:
Mailing address:
  • Phone: 140-733-4874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: