Provider Demographics
NPI:1790882272
Name:EKSTRAND, CHRISTINE KOHLER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:KOHLER
Last Name:EKSTRAND
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 1:5258 LINTON BLVD.
Mailing Address - Street 2:305
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:954-251-6051
Mailing Address - Fax:
Practice Address - Street 1:5258 LINTON BLVD.
Practice Address - Street 2:305
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:954-251-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71116207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15342AMedicare ID - Type Unspecified