MEDICARE: J CHRISTIE MD PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	208VP0000X	Pain Medicine Physician
3	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1578710315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J CHRISTIE MD PA

Provider Business Mailing Address
First Line	:	6094 14TH ST W # 119
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-4104
Country	:	US
Telephone Number	:	941-360-1566
Fax Number	:

Provider Business Practice Location Address
First Line	:	2407 CYPRESS RIDGE BLVD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6312
Country	:	US
Telephone Number	:	813-357-5900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOAN M CHRISTIE
Credential	:	MD
Telephone Number	:	941-360-1566

Provider Enumeration Date	:	08/23/2008
Last Update Date	:	08/23/2008

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