MEDICARE: CHRISTOPHER LOW PLASTIC SURGERY PA

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	2086S0122X	Plastic and Reconstructive Surgery Physician	ME112335	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
2	ME112335	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1518409689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER LOW PLASTIC SURGERY PA

Provider Business Mailing Address
First Line	:	906 NE 26TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3607
Country	:	US
Telephone Number	:	954-533-8029
Fax Number	:

Provider Business Practice Location Address
First Line	:	906 NE 26TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3607
Country	:	US
Telephone Number	:	954-533-8029
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	CHRISTOPHER LOW
Credential	:	MD
Telephone Number	:	954-533-8029

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	11/07/2016

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