Basic Information
| Provider Information | |||||||||
| NPI: | 1669406617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAPUTA | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 S HIGHLAND AVE | ||||||||
| Address2: | APT 123 | ||||||||
| City: | TARPON SPRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279474075 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1296 W BROAD STREET | ||||||||
| Address2: | |||||||||
| City: | GROVELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524294104 | ||||||||
| FaxNumber: | 3524295606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME47402 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.