Provider Demographics
NPI:1689674178
Name:PALADINO, CHRISTOPHER (DPM)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PALADINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:PALADINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:28089 VANDERBILT DRIVE
Mailing Address - Street 2:#104
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7521
Mailing Address - Country:US
Mailing Address - Phone:239-498-1176
Mailing Address - Fax:239-498-5877
Practice Address - Street 1:28089 VANDERBILT DR
Practice Address - Street 2:#104
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7521
Practice Address - Country:US
Practice Address - Phone:239-498-1176
Practice Address - Fax:239-498-5877
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002435213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65364XMedicare PIN