Individual
DR. JOHN A CRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1443 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3206
(863) 686-6200
(813) 752-0093
Mailing address
1130 CREEKSIDE PKWY, BOX 111324, NAPLES, FL 34108-1153
(239) 272-1185
(718) 732-2063
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 1768
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO 1768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201805
STAYWELL PIN
FL
01
—
480012416
RAILROAD MEDICARE
FL
01
—
593105185
TAX ID
FL
Enumeration date
01/17/2007
Last updated
02/22/2024
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