Healthcare Provider Details

I. General information

NPI: 1750156402
Provider Name (Legal Business Name): CHALEFF VISION GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 11/21/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 82ND AVE STE 406
PLANTATION FL
33324-7808
US

IV. Provider business mailing address

201 NW 82ND AVE STE 406
PLANTATION FL
33324-7808
US

V. Phone/Fax

Practice location:
  • Phone: 954-646-6906
  • Fax:
Mailing address:
  • Phone: 954-646-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEC JORDAN CHALEFF
Title or Position: OWNER
Credential: MD
Phone: 954-646-6906