Provider Demographics
NPI:1750728051
Name:CHRISTOLIAS, CHRISTOS CONSTANTINE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOS
Middle Name:CONSTANTINE
Last Name:CHRISTOLIAS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2055
Mailing Address - Country:US
Mailing Address - Phone:844-630-0700
Mailing Address - Fax:877-374-1924
Practice Address - Street 1:1400 N US HIGHWAY 441 STE 930
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6812
Practice Address - Country:US
Practice Address - Phone:352-750-2108
Practice Address - Fax:352-750-1836
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2025-05-08
Deactivation Date:2021-11-13
Deactivation Code:
Reactivation Date:2022-02-03
Provider Licenses
StateLicense IDTaxonomies
FLME139495207R00000X, 208M00000X
NJ25MA10703000208M00000X, 207R00000X
NY288558-1208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist