Individual
ALEXIS CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2301 SANTA LUCIA ST, KISSIMMEE, FL 34743-3339
(786) 730-0035
Mailing address
2301 SANTA LUCIA ST, KISSIMMEE, FL 34743-3339
(786) 730-0035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1600-P.A
PR
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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