Provider Demographics
NPI:1760440432
Name:CHAPEL PODIATRY & ASSOCIATES PA
Entity Type:Organization
Organization Name:CHAPEL PODIATRY & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHAPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-684-1444
Mailing Address - Street 1:12084 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-7371
Mailing Address - Country:US
Mailing Address - Phone:352-684-1444
Mailing Address - Fax:352-515-0920
Practice Address - Street 1:12084 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-7371
Practice Address - Country:US
Practice Address - Phone:352-684-1444
Practice Address - Fax:352-515-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1400257OtherGHI
FL480034411OtherRAILROAD MEDICARE
FLE2710ZOtherMEDICARE
FL65693OtherBC
FL340167700Medicaid
FL480031580OtherRAILROAD MEDICARE
FL1400257OtherGHI
FL480034411OtherRAILROAD MEDICARE
FL480031580OtherRAILROAD MEDICARE