# CHEQUITA HILVERSUM, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407413628
- **Authorized official:** DR. CHEQUITA FARINA HILVERSUM OD (AMBR/MANAGING MEMBER)
- **Authorized official phone:** (850) 819-9450

## Contact information

- **Practice address:** 1621 MAIN ST, CHIPLEY, FL 32428-5992
- **Practice address phone:** (850) 638-3214
- **Mailing address:** 4738 CHEROKEE HEIGHTS RD, PANAMA CITY, FL 32404-2023
- **Mailing address phone:** (850) 819-9450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2019
- **Last updated:** 05/22/2019