Organization
CHIEFLAND HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHWIN KOLAVENTY (CHIEF EXECUTIVE OFFICER)
(352) 414-2270
Entity
Organization
Contact information
Practice address
304 N MAIN ST, CHIEFLAND, FL 32626-0803
(352) 507-2000
Mailing address
304 N MAIN ST, CHIEFLAND, FL 32626-0803
(352) 545-4644
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
208800000X
Urology Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/12/2020
Last updated
04/19/2022
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