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NPI Code Detail

MEDICARE: RAYEN-AYOUB CHAKRA

MEDICARE: RAYEN-AYOUB CHAKRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician92836GA
2390200000XStudent in an Organized Health Care Education/Training Program
3207RI0200XInfectious Disease PhysicianME162228FL

General Provider Information

NPI Number : 1033608765
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYEN-AYOUB CHAKRA
Provider Business Mailing Address
First Line : 1710 LISENBY AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3730
Country : US
Telephone Number : 850-807-4420
Fax Number : 850-862-0605
Provider Business Practice Location Address
First Line : 1710 LISENBY AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3730
Country : US
Telephone Number : 850-807-4420
Fax Number : 850-862-0605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2018
Last Update Date : 10/03/2023

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Directions to “ RAYEN-AYOUB CHAKRA ” Practice Location

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