=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154758290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHAYEL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2013
-----------------------------------------------------
Last Update Date | 10/03/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3011 EXCHANGE CT
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33409-4003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-452-3087
-----------------------------------------------------
Fax | 866-452-8903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2912 SHAUGHNESSY DR
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-6498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-323-1590
-----------------------------------------------------
Fax | 866-452-8903
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DR. YVETTE PAMELA KANARICK
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 305-323-1590
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------