Provider Demographics
NPI:1033378542
Name:CHONKA, JOHN A (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:CHONKA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 N FEDERAL HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6700
Mailing Address - Country:US
Mailing Address - Phone:954-785-0900
Mailing Address - Fax:954-786-3497
Practice Address - Street 1:3170 N FEDERAL HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6700
Practice Address - Country:US
Practice Address - Phone:954-785-0900
Practice Address - Fax:954-786-3497
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY547231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY547OtherSTATE LICENSE NUMBER