MEDICARE: CHRISTINA MARIE ECKER D.O.

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	208000000X	Pediatrics Physician	OS10284	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396943759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MARIE ECKER D.O.

Provider Business Mailing Address
First Line	:	900 S PINE ISLAND RD STE 800
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3923
Country	:	US
Telephone Number	:	561-798-9417
Fax Number	:	561-798-9419

Provider Business Practice Location Address
First Line	:	4510 PGA BLVD STE 101
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3968
Country	:	US
Telephone Number	:	561-627-7930
Fax Number	:	561-627-9574

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	09/25/2019

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