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General NPI Number Information
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NPI Number | 1811687130
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Entity Type | Individual
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Provider Name | NATHANIEL CASEY CHRISTAKIS
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Gender | Male
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 1139 NIKKI VIEW DR
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City | BRANDON
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State | FL
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Zip | 33511-4879
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Country | US
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Telephone | 813-879-8045
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 TRAIL HOLLOW RD
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City | COSBY
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State | TN
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Zip | 37722-2118
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Country | US
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Telephone | 708-218-3114
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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