Provider Demographics
NPI:1568056596
Name:CHAWAN, CHANDRASHEKHAR VASANT (PHD FSLS)
Entity Type:Individual
Prefix:
First Name:CHANDRASHEKHAR
Middle Name:VASANT
Last Name:CHAWAN
Suffix:
Gender:M
Credentials:PHD FSLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 CLARK ST STE B
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-2900
Mailing Address - Country:US
Mailing Address - Phone:407-632-3093
Mailing Address - Fax:
Practice Address - Street 1:875 CLARK ST STE B
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-2900
Practice Address - Country:US
Practice Address - Phone:407-632-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty