Individual
ISMARY CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 NE 167TH ST, N MIAMI BEACH, FL 33162-2304
(305) 940-0522
(305) 653-1138
Mailing address
1558 NW 159TH AVE, PEMBROKE PINES, FL 33028-1696
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107555
FL
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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