MEDICARE: DORA O CHIZEA M.D.

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	174400000X	Specialist	ME92876	FL

General Provider Information

NPI Number	:	1780767509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORA O CHIZEA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 511596
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33951-1596
Country	:	US
Telephone Number	:	941-637-6380
Fax Number	:	941-347-8244

Provider Business Practice Location Address
First Line	:	2310 TAMIAMI TRL UNIT 2101
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-5934
Country	:	US
Telephone Number	:	941-637-1076
Fax Number	:	941-637-7226

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	04/26/2013

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Directions to “ DORA O CHIZEA M.D.” Practice Location

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