Provider Demographics
NPI:1417145137
Name:CHRIS R CHOAT OD PA
Entity Type:Organization
Organization Name:CHRIS R CHOAT OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHOAT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-895-4400
Mailing Address - Street 1:215 E NEW HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6403
Mailing Address - Country:US
Mailing Address - Phone:407-895-4400
Mailing Address - Fax:407-264-8671
Practice Address - Street 1:215 E NEW HAMPSHIRE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6403
Practice Address - Country:US
Practice Address - Phone:407-895-4400
Practice Address - Fax:407-264-8671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3694152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K9398Medicare PIN