MEDICARE: CHRISTOPHER RIDER MD

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	207Q00000X	Family Medicine Physician	ME167715	FL

General Provider Information

NPI Number	:	1558943787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER RIDER MD

Provider Business Mailing Address
First Line	:	978 HERITAGE PASS
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33896-9117
Country	:	US
Telephone Number	:	407-635-5956
Fax Number	:

Provider Business Practice Location Address
First Line	:	978 HERITAGE PASS
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33896-9117
Country	:	US
Telephone Number	:	407-635-5956
Fax Number	:	321-841-6974

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

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/03/2025

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