Individual
CHRISTOPHER J BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0023
(407) 483-1064
Mailing address
206 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0023
(407) 483-1064
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5194600
FL
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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