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NPI Code Detail

MEDICARE: ERIC SCOTT CHENVEN M.D.

MEDICARE: ERIC SCOTT CHENVEN M.D.
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
1208800000XUrology PhysicianME87659FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6P00731868OTHERFLRAILROAD MEDICARE
9PRL00000274253OTHERFLPREFERRED MEDICAL PLAN (COMM/MEDICARE)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11192963OTHERFLWELLCARE
279056OTHERFLBLUECROSS BLUESHIELD OF FL
3000056842ZOTHERFLHUMANA
4P0003137OTHERFLFLORIDA HEALTHCARE PLUS
56902213OTHERFLCIGNA
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
811985OTHERFLMEDICA
1010201OTHERFLDIMENSION HEALTH
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962493619
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC SCOTT CHENVEN M.D.
Provider Business Mailing Address
First Line : 2234 COLONIAL BLVD
Second Line : MANAGED CARE DEPT.
City : FORT MYERS
State : FL
Zip : 33907-1412
Country : US
Telephone Number : 239-931-7342
Fax Number : 239-931-7385
Provider Business Practice Location Address
First Line : 1200 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2134
Country : US
Telephone Number : 954-463-6408
Fax Number : 954-463-1858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 04/28/2016

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