Provider Demographics
NPI:1184819344
Name:CHAVARRO, NANCY ELENA (CNA)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELENA
Last Name:CHAVARRO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PINE ISLAND CIRCLE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-0000
Mailing Address - Country:US
Mailing Address - Phone:407-348-3194
Mailing Address - Fax:407-348-3194
Practice Address - Street 1:48 PINE ISLAND CIRCLE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-0000
Practice Address - Country:US
Practice Address - Phone:407-348-3194
Practice Address - Fax:407-348-3194
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA866193747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692706896Medicaid