Provider Demographics
NPI:1841814407
Name:MCGHIE, CHRISTOPHER L
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:MCGHIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21409 NW 13TH CT APT 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-7421
Mailing Address - Country:US
Mailing Address - Phone:305-249-2130
Mailing Address - Fax:
Practice Address - Street 1:21409 NW 13TH CT APT 105
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-7421
Practice Address - Country:US
Practice Address - Phone:305-249-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily