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Individual

MARK H. CHRIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
21150 BISCAYNE BLVD, 404, AVENTURA, FL 33180-1226
(305) 466-9111
(305) 466-9127
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME64903
FL
208800000X
Urology Physician
Primary
ME0064903
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1192976
WELLCARE
FL
01
23537
BCBS FL
FL
05
275036800
FL
01
4598716
AETNA PROVIDER #
FL
01
P0003144
FLORIDA HEALTHCARE PLUS
FL
01
P00721038
RR MEDICARE
FL
01
P01730152
SIMPLY HEALTHCARE
FL
Enumeration date
04/13/2006
Last updated
04/28/2016
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