Provider Demographics
NPI:1922446848
Name:VANBENSCHOTEN, CHRISTOPHER LEE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:VANBENSCHOTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 RIVERSIDE DR
Mailing Address - Street 2:UNIT 1203
Mailing Address - City:HOLLY HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32117
Mailing Address - Country:US
Mailing Address - Phone:772-321-9721
Mailing Address - Fax:
Practice Address - Street 1:1301 SOLANA BLVD BLDG 2
Practice Address - Street 2:# 2200
Practice Address - City:WESTLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262-1659
Practice Address - Country:US
Practice Address - Phone:817-767-6111
Practice Address - Fax:817-582-0359
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL130449207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine