Individual
ELENI CHALVADAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1360 E VENICE AVE, VENICE, FL 34285-9066
(941) 488-2020
(941) 484-2200
Mailing address
1360 E VENICE AVE, VENICE, FL 34285-9066
(941) 488-2020
(941) 484-2200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9105632
STATE LICENSE #
FL
Enumeration date
01/10/2011
Last updated
02/24/2022
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