Provider Demographics
NPI:1548326499
Name:CHRISTAKIS, JOHN E (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:CHRISTAKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S DIXIE HWY
Mailing Address - Street 2:STE 103
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6034
Mailing Address - Country:US
Mailing Address - Phone:561-395-1011
Mailing Address - Fax:
Practice Address - Street 1:600 S DIXIE HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6034
Practice Address - Country:US
Practice Address - Phone:561-395-1011
Practice Address - Fax:561-395-6014
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL38986207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC1326657OtherDEA NUMBER
61246YMedicare PIN
FLAC1326657OtherDEA NUMBER