Provider Demographics
NPI:1598298895
Name:CHALEFF, ALEC JORDAN (MD)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:JORDAN
Last Name:CHALEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NW 82ND AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7808
Mailing Address - Country:US
Mailing Address - Phone:754-312-5105
Mailing Address - Fax:
Practice Address - Street 1:201 NW 82ND AVE STE 406
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:754-312-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME154232207WX0120X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4490078OtherCIGNA IND
K0138OtherMEDICARE PTAN GROUP
FL3041058OtherUHC GROUP
FLDFM1NOtherBCBS IND
FLPJ743OtherMEDICARE IND