Healthcare Provider Details

I. General information

NPI: 1518176171
Provider Name (Legal Business Name): MRS. CHRISTINA BATES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 MARINER BLVD
SPRING HILL FL
34609-5691
US

IV. Provider business mailing address

13082 HAVERHILL DR
SPRING HILL FL
34609-0640
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-2120
  • Fax:
Mailing address:
  • Phone: 845-742-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3563
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number006406
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number26324
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: