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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

CHRISTO W KOULISIS, MD
1003 COLLEGE BLVD W
SUITE 4
NICEVILLE, FL32578-1068
 Phone: 850-279-6485
 Fax: 850-279-6546
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for CHRISTO W KOULISIS · (Male)

NPI Number 1780673749
Credentials MD
Entity Individual
Enumeration date 10/20/2005
Last updated 10/16/2012 - About 4 years ago
Sole proprietor 1 No
Identifiers
FL License # ME0053933
FL Medicaid 256355000
Medicare (Unspecified) 07915
Medicare UPIN B24093
FL Other 07915 BLUE CROSS BLUE SHIELD
FL Other 162510700 DEPARTMENT OF LABOR
Hospital affiliation(s)
  • SOUTHCOAST HOSPITAL GROUP INC - (Acute Care)
    363 HIGHLAND AVENUE
    FALL RIVER, MA 02720
  • ST ANTHONY HOSPITAL - (Acute Care)
    11567 CANTERWOOD BOULEVARD NW
    GIG HARBOR, WA 98332
  • ST JOSEPH MEDICAL CENTER - (Acute Care)
    1717 SOUTH J STREET
    TACOMA, WA 98405
  • TWIN CITIES HOSPITAL - (Acute Care)
    2190 HWY 85 N
    NICEVILLE, FL 32578
  • WOMAN'S CHRISTIAN ASSOCIATION - (Acute Care)
    207 FOOTE AVENUE
    JAMESTOWN, NY 14701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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