Basic Information
Provider Information
NPI: 1609862671
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOMBARDI
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4519 GEORGE RD
Address2: STE 100
City: TAMPA
State: FL
PostalCode: 336347329
CountryCode: US
TelephoneNumber: 8134961075
FaxNumber:  
Practice Location
Address1: 17240 CORTEZ BLVD
Address2:  
City: BROOKSVILLE
State: FL
PostalCode: 346018978
CountryCode: US
TelephoneNumber: 3527545400
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/23/2005
LastUpdateDate: 01/02/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME77431FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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