Provider Demographics
NPI:1760505341
Name:ABRASLEY, CHRISTOPHER DALE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DALE
Last Name:ABRASLEY
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 1:1005 MAR WALT DRIVE
Mailing Address - Street 2:ADMINISTRATION
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6707
Mailing Address - Country:US
Mailing Address - Phone:850-863-8131
Mailing Address - Fax:850-863-4152
Practice Address - Street 1:1032 MAR WALT DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6707
Practice Address - Country:US
Practice Address - Phone:850-863-8260
Practice Address - Fax:850-862-6098
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92543207R00000X, 207RG0100X
MS18960207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL281351300Medicaid
FLAL375ZMedicare PIN