Healthcare Provider Details

I. General information

NPI: 1669401774
Provider Name (Legal Business Name): ALEJANDRO D CHEDIAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7029 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

IV. Provider business mailing address

7029 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-2224
  • Fax: 305-666-2297
Mailing address:
  • Phone: 305-666-2224
  • Fax: 305-666-2297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME51163
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME51163
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: