Provider Demographics
NPI:1548418700
Name:PIERRE, CHRISTINE CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CLAIRE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 KINGSLEY AVE
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4416
Mailing Address - Country:US
Mailing Address - Phone:904-272-9981
Mailing Address - Fax:904-272-9982
Practice Address - Street 1:1887 KINGSLEY AVE
Practice Address - Street 2:SUITE 1900
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4416
Practice Address - Country:US
Practice Address - Phone:904-272-9981
Practice Address - Fax:904-272-9982
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102950174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002829700Medicaid
FLCC746YMedicare PIN
FLCC746ZMedicare PIN