Basic Information
Provider Information
NPI: 1063467009
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPUTO
FirstName: CHRISTOPHER
MiddleName: PATRICK
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4645 NW 8TH AVE
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326054524
CountryCode: US
TelephoneNumber: 3522642500
FaxNumber: 3523319095
Practice Location
Address1: 4645 NW 8TH AVE
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326054524
CountryCode: US
TelephoneNumber: 3522642500
FaxNumber: 3523319095
Other Information
ProviderEnumerationDate: 05/24/2006
LastUpdateDate: 04/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0011XOS8929FLY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
207RC0000XOS8929FLN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
26718910005FL MEDICAID
CM855001FLMEDICARE RROTHER
7882501FLBLUECROSS FLOTHER


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