Provider Demographics
NPI:1093885709
Name:CANODY, CHRISTINA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:JOY
Last Name:CANODY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4712 N ARMENIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2611
Mailing Address - Country:US
Mailing Address - Phone:813-879-5716
Mailing Address - Fax:813-877-4890
Practice Address - Street 1:4712 N ARMENIA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2611
Practice Address - Country:US
Practice Address - Phone:813-879-5716
Practice Address - Fax:813-877-4890
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 79056208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019261400Medicaid