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General NPI Number Information
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NPI Number | 1194550970
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Entity Type | Individual
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Provider Name | CHRISTOPHER MCSHAN
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Gender | Male
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 1180 SPRING CENTRE SOUTH BLVD STE 221
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1955
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Country | US
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Telephone | 321-297-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 2531 SUGARSAND CT
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City | APOPKA
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State | FL
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Zip | 32712-5040
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Country | US
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Telephone | 321-297-5003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | E04376
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License Number State | FL
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