MEDICARE: HEINZ C CHAVEZ MD

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
1	208000000X	Pediatrics Physician	ME88877	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427019439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEINZ C CHAVEZ MD

Provider Business Mailing Address
First Line	:	801 6TH ST S
Second Line	:	DEPT 6941
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4816
Country	:	US
Telephone Number	:	727-767-4429
Fax Number	:	727-767-4970

Provider Business Practice Location Address
First Line	:	801 6TH ST S
Second Line	:	DEPT 7835
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4816
Country	:	US
Telephone Number	:	727-767-8917
Fax Number	:	727-767-8519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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Directions to “ HEINZ C CHAVEZ MD” Practice Location

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