Healthcare Provider Details

I. General information

NPI: 1558726943
Provider Name (Legal Business Name): CHANTAL MEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13145 SW 107TH TER
MIAMI FL
33186-3460
US

IV. Provider business mailing address

13145 SW 107TH TER
MIAMI FL
33186-3460
US

V. Phone/Fax

Practice location:
  • Phone: 305-608-3687
  • Fax: 305-233-4666
Mailing address:
  • Phone: 305-608-3687
  • Fax: 305-233-4666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: