Healthcare Provider Details

I. General information

NPI: 1477340438
Provider Name (Legal Business Name): CHRISTOPHER REGISTER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8112 CENTRALIA CT STE 101
LEESBURG FL
34788-3701
US

IV. Provider business mailing address

415 CR 487A
LAKE PANASOFFKEE FL
33538-5849
US

V. Phone/Fax

Practice location:
  • Phone: 352-251-2588
  • Fax:
Mailing address:
  • Phone: 352-556-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number11038121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: