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Organization
JIRAYOS CHINTANADILOK
Active
Organization
JIRAYOS CHINTANADILOK
Active
Other names
Everest Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
JIRAYOS CHINTANADILOK M.D. (M.D. (OWNER))
(850) 482-2061
Entity
Organization
Contact information
Practice address
4296 5TH AVE, MARIANNA, FL 32446-2173
(850) 482-2061
(850) 482-6617
Mailing address
4296 5TH AVE, MARIANNA, FL 32446-2173
(850) 482-2061
(850) 482-6617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME27861
FL
207R00000X
Internal Medicine Physician
ME77246
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME77246
FL
207RP1001X
Pulmonary Disease Physician
ME77246
FL
363AM0700X
Medical Physician Assistant
PA9101074
FL
363LG0600X
Gerontology Nurse Practitioner
ARNP
FL
363LP2300X
Primary Care Nurse Practitioner
ARNP1903302
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269074800
—
FL
Enumeration date
06/30/2005
Last updated
08/04/2008
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