Provider Demographics
NPI:1447753934
Name:CHABER, MARYANN
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:CHABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARYANN
Other - Middle Name:
Other - Last Name:OLIVERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8602 WELLINGTON LOOP
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1625
Mailing Address - Country:US
Mailing Address - Phone:954-465-9868
Mailing Address - Fax:
Practice Address - Street 1:394 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4009
Practice Address - Country:US
Practice Address - Phone:407-914-9168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA71817225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist