Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ARNP9329665 | FL |
NPI | 1275081291 |
---|---|
Provider Name | Cheslyn Alphonse |
First Address | Maitland, FL 32751-7003 |
Second Address | Maitland, FL 32751-7003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2016 |
Last Update Date | 17/03/2018 |