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General NPI Number Information
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NPI Number | 1053506790
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Entity Type | Organization
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Legal Business Name | NATALIO J CHEDIAK MD PA
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 660 GLADES RD SUITE 220
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City | BOCA RATON
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State | FL
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Zip | 33431-6466
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Country | US
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Telephone | 561-750-9881
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Fax | 561-750-9644
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Provider Business Mailing Address
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Address Line | 660 GLADES ROAD SUITE 220
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City | BOCA RATON
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State | FL
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Zip | 33431-6466
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Country | US
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Telephone | 561-750-9881
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Fax | 561-750-9644
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NATALIO J CHEDIAK
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Credential | MD
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Telephone | 561-750-9881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME45193
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License Number State | FL
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