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MALIKA M CHACON LMT
>> Point of Service >> Managed Care OrganizationsRegistrant NPI Number: 1437403607
Individual Registrant: MALIKA M CHACON LMT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
14616 NW 140TH ST ALACHUA, FL 32615-6261 US
Tel: 352-317-4713 Fax: --
Tel: 352-317-4713 Fax: --
Contact information for business:
15092 NW 147TH DR ALACHUA, FL 32615-5305 US
Tel: 352-317-4713 Fax: --
Tel: 352-317-4713 Fax: --
Registration Information:
NPI: 1437403607
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 305S00000X | Managed Care Organizations Point of Service | FL | MA57939 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
