CHANUN PARK DO PA (NPI# 1619126323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619126323 |
| Entity Type | Organization |
| Organization Name | CHANUN PARK DO PA |
| Practice Address |
1220 Business Way Unit 1 Lehigh Acres FL 33936-6007 |
| Practice Telephone | 2393694155 |
| Practice Fax Number | 2393691950 |
| Mailing Telephone | 2393694155 |
| Mailing Fax Number | 2393691950 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-11-24 |
| Authorized Official Name | DR. CHANUN DUSTIN PARK (PRESIDENT) |
| Authorized Official Telephone | 2393694155 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
OS8128 | FL | Ambulatory Health Care Facilities |
| Street Address |
1220 BUSINESS WAY UNIT 1 |
| City | LEHIGH ACRES |
| State | FL |
| Zip Code | 33936-6007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629038161 | Chanun Dustin Park | Internal Medicine | 1220 Business Way, Unit 1, Lehigh Acres, FL 33936-6007 | 2006-03-27 |
| 1285185835 | Cameren J Hackley | Nurse Practitioner | 1220 Business Way, Suite 2, Lehigh Acres, FL 33936-6073 | 2016-10-19 |
| 1093889529 | Jerilee Emma Lomas | Internal Medicine | 1220 Business Way, Suite 2, Lehigh Acres, FL 33936 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497241939 | Happy Learning, LLC | Clinic/Center | 1400 Kimdale St E Ste 2, Lehigh Acres, FL 33936 | 2018-07-09 |
| 1184112906 | Fenix Behavior Therapy Co. | Behavioral Analyst | 15 Roosevelt Ave, Lehigh Acres, FL 33936 | 2018-04-26 |
| 1548781586 | Cossette Maiquez | Nurse Practitioner | 448 Morgan Circle South, Lehigh Acres, FL 33936 | 2017-06-29 |
| 1124567714 | Sweet Home Adult Day Care, LLC. | Clinic/Center | 201 Plaza Drive Suite #102, Lehigh Acres, FL 33936 | 2017-02-16 |
| 1306106612 | Darry Dean Griebel | Veterinarian | 21 S. Homestead Rd, Lehigh Acres, FL 33936 | 2012-05-21 |
| 1538469838 | V-20 Medical Services Inc | General Practice | 1420-1422 Lee Blvd, Lehigh Acres, FL 33936 | 2010-11-02 |
| 1093808552 | Abdel R Aryan | Pharmacist | 57 Homestead Rd No., Lehigh Acres, FL 33936 | 2006-10-02 |
| 1265534663 | Steve G Hunter | Pharmacist | 415 Homestead Rd, Lehigh Acres, FL 33936 | 2006-09-05 |
| 1699702035 | Florence Faye Doman | Internal Medicine | Lehigh Regional Medical Center, 1500 Lee Blvd., Lehigh Acres, FL 33936 | 2006-06-28 |
| 1396732970 | Joseph Francis Avey | Family Medicine | 260 Beth Stacey Blvd, Suite 130, Lehigh Acres, FL 33936 | 2005-09-29 |
| Find all providers in zip 33936 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1972123628 | Taylormedi Family Care Clinic | Clinic/Center | 243 Bethany Home Dr, Lehigh Acres, FL 33936-7566 | 2020-04-23 |
| 1205460995 | Suncoast Medical Group LLC | Clinic/Center | 1154 Lee Blvd Ste 4, Lehigh Acres, FL 33936-4852 | 2020-03-03 |
| 1730739053 | Florida Best Primary Crae Services, LLC | Clinic/Center | 2718 Lee Blvd Ste B, Lehigh Acres, FL 33971-1537 | 2019-09-18 |
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| Find all providers with the same taxonomy | ||||
| City | LEHIGH ACRES |
| Zip Code | 33936 |
Please comment or provide details below to improve the information on CHANUN PARK DO PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.