Healthcare Provider Details

I. General information

NPI: 1639576622
Provider Name (Legal Business Name): LUIS F CHAVEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ALEXANDER ST STE 200
ROCHESTER NY
14607-4000
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-8400
  • Fax: 585-922-8405
Mailing address:
  • Phone: 585-275-2901
  • Fax: 585-273-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number285135
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: