=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922810787
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA LORENA CHIRIBOGA CHI SPANISH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2025
-----------------------------------------------------
Last Update Date | 01/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3540 NW 30TH BLVD
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32605-2609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-600-2103
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 MALLET HILL RD
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29223-3216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-600-2103
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171R00000X
-----------------------------------------------------
Taxonomy Name | Interpreter
-----------------------------------------------------
License Number | 025055
-----------------------------------------------------
License Number State |
-----------------------------------------------------