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General NPI Number Information
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NPI Number | 1780125088
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Entity Type | Individual
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Provider Name | CHRISTOPHER FRATANGELO ARNP
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 1730 DUNLAWTON AVE
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City | PORT ORANGE
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State | FL
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Zip | 32127-8985
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Country | US
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Telephone | 386-320-3299
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Fax | 877-991-1880
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Provider Business Mailing Address
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Address Line | 916 PELICAN BAY DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1364
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Country | US
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Telephone | 386-307-8421
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 9334292
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License Number State | FL
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