Provider Demographics
NPI:1962454082
Name:CHALAL, JOSEPH B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:CHALAL
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 1:7593 BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6154
Mailing Address - Country:US
Mailing Address - Phone:561-733-5888
Mailing Address - Fax:888-714-5190
Practice Address - Street 1:6056 BOYNTON BEACH BLVD STE 215
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3500
Practice Address - Country:US
Practice Address - Phone:561-733-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00443888OtherMEDICARE RAIL ROAD
FL04750OtherBCBS
FL4365337OtherAETNA
FL047076700Medicaid
FL25639OtherNEIGHBORHOOD HEALTH
FLP00443888OtherMEDICARE RAIL ROAD