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NPI Code Detail

MEDICARE: JORGE CHAVES CSA

MEDICARE: JORGE CHAVES CSA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246ZC0007XSurgical Assistant

General Provider Information

NPI Number : 1336391366
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE CHAVES CSA
Provider Business Mailing Address
First Line : 1995 E OAKLAND PARK BLVD STE 250
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33306-1149
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Provider Business Practice Location Address
First Line : 1995 E OAKLAND PARK BLVD STE 250
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33306-1149
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2008
Last Update Date : 01/23/2020

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Directions to “ JORGE CHAVES CSA” Practice Location

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