Healthcare Provider Details

I. General information

NPI: 1689814774
Provider Name (Legal Business Name): CHASCIONE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 03/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13940 N US HIGHWAY 441 SUITE 906
THE VILLAGES FL
32159-8908
US

IV. Provider business mailing address

9069 SE 136TH LOOP
SUMMERFIELD FL
34491-7977
US

V. Phone/Fax

Practice location:
  • Phone: 352-205-8305
  • Fax: 352-750-1993
Mailing address:
  • Phone: 772-708-7621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA H GEORGIADES
Title or Position: OWNER
Credential:
Phone: 772-708-7621