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General NPI Number Information
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NPI Number | 1730627621
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Entity Type | Individual
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Provider Name | CHRISTIAN ESTEVEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 3618 LANTANA RD STE 202
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City | LAKE WORTH
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State | FL
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Zip | 33462-2247
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Country | US
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Telephone | 561-296-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 5375 SW ORCHID BAY DR
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City | PALM CITY
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State | FL
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Zip | 34990-8520
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Country | US
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Telephone | 772-708-7189
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9110121
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9110121
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9110121
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License Number State | FL
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