Provider Demographics
NPI:1538186317
Name:MARITATO, CHRISTOPHER JOHN (DO)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:MARITATO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160448
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33116-0448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3410
Practice Address - Country:US
Practice Address - Phone:828-696-1000
Practice Address - Fax:828-696-1314
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600286207P00000X
FLOS8219207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCY421AOtherMEDICARE
FL30028OtherBLUE CROSS OF FLORIDA
FL273466400Medicaid
FLP01003998OtherMEDICARE RAILROAD
FLU5806XMedicare PIN
FL30028OtherBLUE CROSS OF FLORIDA
FLP01003998OtherMEDICARE RAILROAD