1154758290 NPI number — CHAYEL INC

Table of content: MELISSA LYNN MATTHEWS C.N.P. (NPI 1548697683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154758290 NPI number — CHAYEL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHAYEL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154758290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2912 SHAUGHNESSY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELLINGTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33414-6498
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-323-1590
Provider Business Mailing Address Fax Number:
866-452-8903

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3011 EXCHANGE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33409-4003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-452-3087
Provider Business Practice Location Address Fax Number:
866-452-8903
Provider Enumeration Date:
10/03/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KANARICK
Authorized Official First Name:
YVETTE
Authorized Official Middle Name:
PAMELA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
305-323-1590

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)