Provider Demographics
NPI:1346763232
Name:MAIS, CHRISTINE (TECHNOLOGIST ARRT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MAIS
Suffix:
Gender:F
Credentials:TECHNOLOGIST ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5455
Mailing Address - Country:US
Mailing Address - Phone:945-234-3579
Mailing Address - Fax:
Practice Address - Street 1:3345 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5455
Practice Address - Country:US
Practice Address - Phone:945-234-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT596002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology