Provider Demographics
NPI:1962654616
Name:DA SILVA-SOSA, CHAUNTEL ERIKA (OD)
Entity type:Individual
Prefix:
First Name:CHAUNTEL
Middle Name:ERIKA
Last Name:DA SILVA-SOSA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHAUNTEL
Other - Middle Name:E
Other - Last Name:DA SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8810 NW 155TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1411
Mailing Address - Country:US
Mailing Address - Phone:305-815-9755
Mailing Address - Fax:
Practice Address - Street 1:8810 NW 155TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-1411
Practice Address - Country:US
Practice Address - Phone:305-815-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006682000Medicaid