Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 20420 | FL |
N | 213EG0000X | General Practice | 20420 | FL |
Y | 1223X0400X | Orthodontists | 20420 | FL |
N | 1223X0400X | Orthodontists | 29255 | TX |
NPI | 1013328129 |
---|---|
Provider Name | Kristina Christoph |
First Address | Miami Lakes, FL 33014-6879 |
Second Address | Miami Lakes, FL 33014-6879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2014 |
Last Update Date | 16/04/2020 |