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General NPI Number Information
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NPI Number | 1164887055
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Entity Type | Organization
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Legal Business Name | PATRICK WILLIAM CHERNESKY
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 4055 TAMIAMI TRL STE 9
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9212
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Country | US
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Telephone | 941-629-1153
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Fax | 941-629-0104
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Provider Business Mailing Address
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Address Line | PO BOX 510885
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City | PUNTA GORDA
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State | FL
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Zip | 33951-0885
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK W CHERNESKY
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Credential | DPM
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Telephone | 941-629-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO1660
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License Number State | FL
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