Provider Demographics
NPI:1619952579
Name:GARRETT, CHRISTINE ELIZABETH (M D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:GARRETT
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELIZABETH
Other - Last Name:BUXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M D
Mailing Address - Street 1:50 LEANNI WAY STE A3-4
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-4751
Mailing Address - Country:US
Mailing Address - Phone:386-225-4900
Mailing Address - Fax:386-225-4748
Practice Address - Street 1:50 LEANNI WAY STE A3-4
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4751
Practice Address - Country:US
Practice Address - Phone:386-225-4900
Practice Address - Fax:386-225-4748
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88007207R00000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH43213Medicare UPIN
FLAF109XMedicare PIN
FL278504800Medicaid
GA22BDDJQMedicare ID - Type Unspecified
GA000969911AMedicaid
GAH43213Medicare UPIN