Individual
CHRISTINE PENSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1625 SEABREEZE BLVD, FORT LAUDERDALE, FL 33316
(508) 561-7595
Mailing address
1625 SEABREEZE BLVD, FORT LAUDERDALE, FL 33316
(508) 561-7595
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME39077
FL
207VX0000X
Obstetrics Physician
ME39077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013244200
—
FL
05
—
3003388
—
MA
Enumeration date
09/15/2005
Last updated
07/21/2022
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