Healthcare Provider Details

I. General information

NPI: 1669026522
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL PARTLOW HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 SW MONTEREY RD
STUART FL
34994-4652
US

IV. Provider business mailing address

2466 44TH AVE
VERO BEACH FL
32966-2045
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-8302
  • Fax:
Mailing address:
  • Phone: 772-633-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: