Provider Demographics
NPI:1871769257
Name:HARTMAN, CHRISTINA LEA (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEA
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 SHIPPING AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4513
Mailing Address - Country:US
Mailing Address - Phone:305-393-2345
Mailing Address - Fax:
Practice Address - Street 1:1501 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-5108
Practice Address - Country:US
Practice Address - Phone:305-295-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104566363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant