Individual
ELYSE MARIE CHAVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3009
(352) 627-9350
Mailing address
PO BOX 100296, GAINESVILLE, FL 32610-0296
(352) 627-9350
(352) 273-9054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME154778
FL
363A00000X
Physician Assistant
PA9107539
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113796000
—
FL
Enumeration date
09/27/2013
Last updated
07/28/2022
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