| Age Defying Experts South Florida | |
|
5379 Lyons Rd # 1599 Coconut Creek FL 33073-2810 | |
| (786) 505-4423 | |
| Not Available |
| Full Name | Age Defying Experts South Florida |
|---|---|
| Speciality | Clinic/Center |
| Location | 5379 Lyons Rd # 1599, Coconut Creek, Florida |
| Authorized Official Name and Position | Daniela Chetan (NURSE PRACTITIONER) |
| Authorized Official Contact | 7865054423 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Age Defying Experts South Florida 5379 Lyons Rd Coconut Creek FL 33073-2810 Ph: (786) 505-4423 | Age Defying Experts South Florida 5379 Lyons Rd # 1599 Coconut Creek FL 33073-2810 Ph: (786) 505-4423 |
| NPI Number | 1588250948 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 10/31/2024 |
| Certification Date | 10/24/2024 |
| Medicare PECOS PAC ID | 9537575154 |
|---|---|
| Medicare Enrollment ID | O20210305001950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588250948 | NPI | - | NPPES |
| Provider Name | Daniela Chetan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972163210 PECOS PAC ID: 3870825425 Enrollment ID: I20191031000010 |
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