Provider Demographics
NPI:1184923567
Name:BOOTH, CHRISTINE C (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:C
Last Name:BOOTH
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 1:32075 WENLOCK LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5457
Mailing Address - Country:US
Mailing Address - Phone:727-642-9225
Mailing Address - Fax:
Practice Address - Street 1:32075 WENLOCK LOOP
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5457
Practice Address - Country:US
Practice Address - Phone:727-642-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118185208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics