Basic Information
| Provider Information | |||||||||
| NPI: | 1255479051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PASTORE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4211 VAN DYKE ROAD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LUTZ | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132299292 | ||||||||
| FaxNumber: | 8132299293 | ||||||||
| Practice Location | |||||||||
| Address1: | 4211 VAN DYKE ROAD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LUTZ | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132299292 | ||||||||
| FaxNumber: | 8132299293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 11/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 96865 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 96865 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207UN0901X | 96865 | FL | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207RI0011X | 96865 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | P1367 | 01 | FL | HF MA | OTHER | 278538200 | 05 | FL | MEDICAID |