Provider Demographics
NPI:1093829905
Name:CHERNESKY, PATRICK (DPM)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:CHERNESKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2826 TAMIAMI TRL
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5167
Mailing Address - Country:US
Mailing Address - Phone:941-629-1153
Mailing Address - Fax:941-629-0104
Practice Address - Street 1:2826 TAMIAMI TRL
Practice Address - Street 2:SUITE 5
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5167
Practice Address - Country:US
Practice Address - Phone:941-629-1153
Practice Address - Fax:941-629-0104
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-1660213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0296856-00Medicaid
FL87992Medicare ID - Type Unspecified
FL0296856-00Medicaid