Provider Demographics
NPI:1407167919
Name:NOBO, CHRISTOPHER NARCISO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NARCISO
Last Name:NOBO
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 1:505 COLUMBIA DR APT 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3937
Mailing Address - Country:US
Mailing Address - Phone:352-514-4778
Mailing Address - Fax:
Practice Address - Street 1:10676 BLOOMINGDALE AVE STE 1
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4292
Practice Address - Country:US
Practice Address - Phone:813-284-6574
Practice Address - Fax:813-284-6803
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC166723207R00000X
FLME120987207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015198500Medicaid
FL015198500Medicaid