Provider Demographics
NPI:1134114432
Name:CHAPARRO, MICHAEL J (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:CHAPARRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:12983 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9207
Mailing Address - Country:US
Mailing Address - Phone:561-333-0415
Mailing Address - Fax:561-795-2864
Practice Address - Street 1:12983 SOUTHERN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9207
Practice Address - Country:US
Practice Address - Phone:561-333-0415
Practice Address - Fax:561-795-2864
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME79186207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257899900Medicaid
FLE3854YMedicare ID - Type Unspecified
FLF47107Medicare UPIN