Blaine S Kristo, MD | |
1348 S 18th St Ste 230, Fernandina Beach, FL 32034-4785 | |
(904) 277-2003 | |
(904) 277-2006 |
Full Name | Blaine S Kristo |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 25 Years |
Location | 1348 S 18th St Ste 230, Fernandina Beach, Florida |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124128822 | NPI | - | NPPES |
0000253955 | Other | HI | HMSA BILLING NUMBER |
572702-01 | Medicaid | HI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | MD-13190 (Hawaii) | Secondary |
208800000X | Urology | ME159017 (Florida) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Accentcare Home Health Of Jacksonville | Orange park, FL | Home health agency |
Baptist Medical Center - Nassau | Fernandina beach, FL | Hospital |
Baptist Health Medical Center - Jacksonville | Jacksonville, FL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Baptist Urology Inc | 6709029614 | 2 |
Entity Name | Baptist Urology Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689011710 PECOS PAC ID: 6709029614 Enrollment ID: O20130826000082 |
Mailing Address | Practice Location Address |
---|---|
Blaine S Kristo, MD Po Box 746643, Atlanta, GA 30374-6643 Ph: (904) 202-1032 | Blaine S Kristo, MD 1348 S 18th St Ste 230, Fernandina Beach, FL 32034-4785 Ph: (904) 277-2003 |
Margeaux Jenee Dennis, DO Urology Medicare: Medicare Enrolled Practice Location: 1348 S 18th St Ste 230, Fernandina Beach, FL 32034 Phone: 904-277-2003 Fax: 904-277-2006 | |
Kenneth A Son, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1348 S 18th St, Fernandina Beach, FL 32034 Phone: 904-227-2003 Fax: 904-277-2006 |