Provider Demographics
NPI:1053506790
Name:NATALIO J CHEDIAK MD PA
Entity Type:Organization
Organization Name:NATALIO J CHEDIAK MD PA
Other - Org Name:BOCA RATON SLEEP DISORDERS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NATALIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHEDIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-750-9881
Mailing Address - Street 1:660 GLADES ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6466
Mailing Address - Country:US
Mailing Address - Phone:561-750-9881
Mailing Address - Fax:561-750-9644
Practice Address - Street 1:660 GLADES RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6466
Practice Address - Country:US
Practice Address - Phone:561-750-9881
Practice Address - Fax:561-750-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45193174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74870OtherBLUE CROSS BLUE SHIELD
FLK6001Medicare PIN