Provider Demographics
NPI:1801839139
Name:CHRISTENSEN, JOHN PETER (MD, DC, MPH)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PETER
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MD, DC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-5133
Mailing Address - Country:US
Mailing Address - Phone:561-655-2225
Mailing Address - Fax:
Practice Address - Street 1:3001 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5133
Practice Address - Country:US
Practice Address - Phone:561-655-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0002363111NX0800X
FL92135207Q00000X, 208100000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9897AMedicare UPIN
FL89833YMedicare UPIN
FL89833Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER