Provider Demographics
NPI:1821005141
Name:CHESTON, PATRICIA LYNN (PAC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:CHESTON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1503 BUENOS AIRES BLVD
Mailing Address - Street 2:110
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:352-205-4302
Mailing Address - Fax:352-430-0468
Practice Address - Street 1:1503 BUENOS AIRES BLVD
Practice Address - Street 2:110
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6821
Practice Address - Country:US
Practice Address - Phone:352-205-4302
Practice Address - Fax:352-430-0468
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA1887363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290918900Medicaid
FL290918900Medicaid
S46928Medicare UPIN