| Chavez Jo Internal Medicine P.a. | |
|
1636 N Central Ave Suite 100 Sebastian FL 32958-3808 | |
| (772) 388-9066 | |
| (772) 388-9067 |
| Full Name | Chavez Jo Internal Medicine P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1636 N Central Ave, Sebastian, Florida |
| Authorized Official Name and Position | Katiusca Chavez (VICE-PRESIDENT) |
| Authorized Official Contact | 7723889066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chavez Jo Internal Medicine P.a. 1636 N Central Ave Suite 100 Sebastian FL 32958-3808 Ph: (772) 388-9066 | Chavez Jo Internal Medicine P.a. 1636 N Central Ave Suite 100 Sebastian FL 32958-3808 Ph: (772) 388-9066 |
| NPI Number | 1922257096 |
|---|---|
| Provider Enumeration Date | 09/15/2008 |
| Last Update Date | 06/22/2009 |
| Medicare PECOS PAC ID | 8921151101 |
|---|---|
| Medicare Enrollment ID | O20090805000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922257096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME 102747 (Florida) | Primary |
| Provider Name | Edgard Chavez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689817843 PECOS PAC ID: 4284787466 Enrollment ID: I20090805000649 |
| Provider Name | Katiusca Chavez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235388307 PECOS PAC ID: 2567515745 Enrollment ID: I20091223000295 |
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