Provider Demographics
NPI:1073638425
Name:WHITE, CHRISTOPHER P (LMT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:P
Last Name:WHITE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6217
Mailing Address - Country:US
Mailing Address - Phone:352-870-3710
Mailing Address - Fax:
Practice Address - Street 1:104 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6217
Practice Address - Country:US
Practice Address - Phone:352-870-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL49192174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist