MEDICARE: CHRISTINA ELIZABETH HEJJA P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9102117	FL

General Provider Information

NPI Number	:	1164639647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ELIZABETH HEJJA P.A.

Provider Business Mailing Address
First Line	:	3100 CORAL HILLS DR STE 305
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4138
Country	:	US
Telephone Number	:	954-575-8056
Fax Number	:	954-575-2563

Provider Business Practice Location Address
First Line	:	3100 CORAL HILLS DR STE 305
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4138
Country	:	US
Telephone Number	:	954-575-8056
Fax Number	:	954-575-2563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	03/25/2009

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