Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME28933 | FL |
NPI | 1114943685 |
---|---|
Provider Name | Dr. Jeffrey P. Chicola |
First Address | Rockland, DE 19732-0191 |
Second Address | Pensacola, FL 32504-8785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 09/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009957685 | (05) | AL |
03276283 | (05) | MS |
058403700 | (05) | FL |
D67154 | (02) |