Provider Demographics
NPI:1104829050
Name:CHAPIN, KEVIN B (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:B
Last Name:CHAPIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3117
Mailing Address - Country:US
Mailing Address - Phone:321-728-8400
Mailing Address - Fax:321-728-8776
Practice Address - Street 1:1314 PINE ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3117
Practice Address - Country:US
Practice Address - Phone:321-728-8400
Practice Address - Fax:321-728-8776
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 4658207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2585367OtherUNITED HEALTHCARE
4341733OtherAETNA
FLF60975Medicare UPIN
FL82621Medicare ID - Type Unspecified