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General NPI Number Information
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NPI Number | 1689649634
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Entity Type | Individual
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Provider Name | CHRISTOPHER BOLTERSDORF PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 460 E ALTAMONTE DR STE 2200
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4653
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Country | US
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Telephone | 407-767-0009
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Fax | 407-767-0022
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Provider Business Mailing Address
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Address Line | 460 E ALTAMONTE DR STE 2200
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4653
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Country | US
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Telephone | 407-767-0009
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Fax | 407-767-0022
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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