Provider Demographics
NPI:1912192998
Name:DANIEL E CHERVONY MD PA AND ASSOCIATES
Entity Type:Organization
Organization Name:DANIEL E CHERVONY MD PA AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:CHERVONY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:957-720-7999
Mailing Address - Street 1:7431 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2956
Mailing Address - Country:US
Mailing Address - Phone:954-720-7999
Mailing Address - Fax:954-720-5335
Practice Address - Street 1:7431 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2956
Practice Address - Country:US
Practice Address - Phone:954-720-7999
Practice Address - Fax:954-720-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061389400Medicaid
FL07597OtherBCBS
FL061389400Medicaid