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NPI Code Detail

MEDICARE: CHRISTINE SUMMERS CORSO PA-C

MEDICARE: CHRISTINE SUMMERS CORSO PA-C
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
1363A00000XPhysician AssistantPA9107474FL

Other Identifiers

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

General Provider Information

NPI Number : 1639503840
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE SUMMERS CORSO PA-C
Provider Business Mailing Address
First Line : 1514 NIRA ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8652
Country : US
Telephone Number : 904-387-4991
Fax Number : 904-384-3613
Provider Business Practice Location Address
First Line : 1514 NIRA ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8652
Country : US
Telephone Number : 904-384-3613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2013
Last Update Date : 02/19/2020

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1720520687 — CHRISTOPHER JAMES KALLINGER PA-C, MMS
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1821531427 — MELISSA GAGLIARDI ARNP
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1518402767 — JACQUELYN O'DONNELL PA-C
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Practice Fax: 904-384-3613

Directions to “ CHRISTINE SUMMERS CORSO PA-C” Practice Location

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