Provider Demographics
NPI:1760449094
Name:WEOT, CHRISTINE JEANETTE (MD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:JEANETTE
Last Name:WEOT
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 1:1609 PASADENA AVE S
Mailing Address - Street 2:3 - H
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4565
Mailing Address - Country:US
Mailing Address - Phone:727-345-9615
Mailing Address - Fax:727-345-9635
Practice Address - Street 1:3152 LITTLE RD
Practice Address - Street 2:# 162
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1864
Practice Address - Country:US
Practice Address - Phone:727-376-6578
Practice Address - Fax:727-376-6784
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44393XOtherBCBS
FLP00254604Medicare PIN
FL44393XOtherBCBS
FL44393Medicare PIN