Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | MA44479 | FL |
NPI | 1457682221 |
---|---|
Provider Name | Juan Chaves |
First Address | Miami, FL 33126-2300 |
Second Address | Miami, FL 33126-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 19/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA44479 | CLINIC/CENTER- HEALTH SERVICES (01) | FL |