Healthcare Provider Details

I. General information

NPI: 1710107271
Provider Name (Legal Business Name): ASTRID MYRZA CHABERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1583 E SILVER STAR RD
OCOEE FL
34761-2553
US

IV. Provider business mailing address

5164 CONWAY RD
ORLANDO FL
32812-1252
US

V. Phone/Fax

Practice location:
  • Phone: 407-770-1414
  • Fax: 407-447-8876
Mailing address:
  • Phone: 407-770-1414
  • Fax: 407-447-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number46925
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN4979
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number135103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: