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NPI Code Detail

MEDICARE: MRS. ROXANA D CHAVEZ BA

MEDICARE: MRS. ROXANA D CHAVEZ BA
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
1104100000XSocial Worker
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1699030387
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROXANA D CHAVEZ BA
Provider Business Mailing Address
First Line : 12220 TOWNE LAKE DR STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8021
Country : US
Telephone Number : 239-433-6700
Fax Number : 239-433-6703
Provider Business Practice Location Address
First Line : 12220 TOWNE LAKE DR STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8021
Country : US
Telephone Number : 239-433-6700
Fax Number : 239-433-6703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2012
Last Update Date : 04/07/2026

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Directions to “ MRS. ROXANA D CHAVEZ BA” Practice Location

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