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1124128822
BLAINE S. KRISTO
FERNANDINA BEACH, FL
NPI
1124128822
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: FL ME159017)
Additional Taxonomies
208800000X Urology
(Licence: HI MD-13190)
Enumeration Date
2006-09-22
Last Update Date
2023-07-06
Business Address
BLAINE S. KRISTO MD
1348 S 18TH ST STE 230
FERNANDINA BEACH, FL 32034-4785
Phone number: 904-277-2003
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Mailing Address
BLAINE S. KRISTO MD
PO BOX 746643
ATLANTA, GA 30374-6643
Phone number: 904-202-1032
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