Individual
CHRISTINE MARIE FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2300 STATE ROAD 524, SUITE 104, COCOA, FL 32926-5894
(321) 868-8320
(321) 632-3445
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 868-8320
(321) 632-3445
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP3328432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306115900
—
FL
Enumeration date
08/03/2005
Last updated
05/29/2018
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