Healthcare Provider Details

I. General information

NPI: 1932816634
Provider Name (Legal Business Name): ANNA CHACON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MADEIRA AVE
CORAL GABLES FL
33134-4515
US

IV. Provider business mailing address

135 MADEIRA AVE
CORAL GABLES FL
33134-4515
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-5733
  • Fax: 305-203-4549
Mailing address:
  • Phone: 305-204-7992
  • Fax: 305-203-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNA CHACON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-204-7992