Healthcare Provider Details

I. General information

NPI: 1952227522
Provider Name (Legal Business Name): CHLOE ALEXANDRA PENA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4744 E SR 64
BRADENTON FL
34208
US

IV. Provider business mailing address

920 MANATEE AVE W APT 810
BRADENTON FL
34205-8832
US

V. Phone/Fax

Practice location:
  • Phone: 941-527-8477
  • Fax: 941-538-6932
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMT-BC20262
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: