Healthcare Provider Details

I. General information

NPI: 1841232253
Provider Name (Legal Business Name): DR. JOHN P CHRISTENSEN P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 BROADWAY
WEST PALM BEACH FL
33407-5133
US

IV. Provider business mailing address

3001 BROADWAY
WEST PALM BEACH FL
33407-5133
US

V. Phone/Fax

Practice location:
  • Phone: 561-655-2225
  • Fax:
Mailing address:
  • Phone: 561-655-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME92135
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN PETER CHRISTENSEN
Title or Position: OWNER
Credential: MD, DC, MPH
Phone: 561-655-2225