1710194725 NPI number — DR. KHRISTIAN A NOTO MD

Table of content: DR. KHRISTIAN A NOTO MD (NPI 1710194725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710194725 NPI number — DR. KHRISTIAN A NOTO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOTO
Provider First Name:
KHRISTIAN
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710194725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 NE MIAMI GARDENS DR STE 221
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33179-4844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-335-0507
Provider Business Mailing Address Fax Number:
305-596-3073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 NE MIAMI GARDENS DR
Provider Second Line Business Practice Location Address:
SUITE 221
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33179-4845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-351-8080
Provider Business Practice Location Address Fax Number:
305-596-3073
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MT185085 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208C00000X , with the licence number: ME110089 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 118499800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com