Basic Information
| Provider Information | |||||||||
| NPI: | 1972690592 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEVAREZ | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2380 W HORIZON RIDGE PKWY | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890525078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028234255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2080 CHILD ST | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322145005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052934600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 0101236815 | VA | N | Allopathic & Osteopathic Physicians | General Practice | 207P00000X | 14036 | NV | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.