Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist |
NPI | 1568056596 |
---|---|
Provider Name | Chandrashekhar Vasant Chawan |
First Address | Oviedo, FL 32765-2900 |
Second Address | Oviedo, FL 32765-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2021 |
Last Update Date | 08/12/2021 |