Provider Demographics
NPI:1790900702
Name:BURNETT-YARNELL, CHRISTIE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:BURNETT-YARNELL
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 1:14111 STATE ROAD 54
Mailing Address - Street 2:PEDIATRIC SURGERY CENTERS
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3663
Mailing Address - Country:US
Mailing Address - Phone:813-343-5690
Mailing Address - Fax:
Practice Address - Street 1:14111 STATE ROAD 54
Practice Address - Street 2:PEDIATRIC SURGERY CENTERS
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-3663
Practice Address - Country:US
Practice Address - Phone:813-343-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7001207LP3000X
FLME 125436207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology