Provider Demographics
NPI:1184619256
Name:BEHAN, CHRISTINE M (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:BEHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14153 YOSEMITE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8060
Mailing Address - Country:US
Mailing Address - Phone:727-868-1943
Mailing Address - Fax:727-819-1290
Practice Address - Street 1:14153 YOSEMITE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8060
Practice Address - Country:US
Practice Address - Phone:727-868-1943
Practice Address - Fax:727-819-1290
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374867700Medicaid
FL374867700Medicaid
FLF69273Medicare UPIN