Provider Demographics
NPI:1275664591
Name:LOUIS B CHAYKIN, M.D., P.A.
Entity Type:Organization
Organization Name:LOUIS B CHAYKIN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:CHAYKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACE,FACP
Authorized Official - Phone:305-931-3269
Mailing Address - Street 1:21110 BISCAYNE BOULEVARD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1227
Mailing Address - Country:US
Mailing Address - Phone:305-931-3269
Mailing Address - Fax:305-931-4867
Practice Address - Street 1:21110 BISCAYNE BOULEVARD
Practice Address - Street 2:SUITE 205
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1227
Practice Address - Country:US
Practice Address - Phone:305-931-3269
Practice Address - Fax:305-931-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0012244207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 0012244OtherST LIC #
FLME 0012244OtherST LIC #
FLK 2141Medicare ID - Type UnspecifiedPA
FLME 0012244OtherST LIC #
FLACO157811OtherDEA