Healthcare Provider Details

I. General information

NPI: 1851738793
Provider Name (Legal Business Name): CHRISTOPHER DE HAYDU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2013
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 SW 117TH AVE STE 304
MIAMI FL
33183-4826
US

IV. Provider business mailing address

8200 SW 117TH AVE STE 304
MIAMI FL
33183-4826
US

V. Phone/Fax

Practice location:
  • Phone: 305-226-5651
  • Fax: 305-226-2244
Mailing address:
  • Phone: 305-226-5651
  • Fax: 305-226-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME132369
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME132369
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: