Provider Demographics
NPI:1013677004
Name:CHAVEZ, ZORAIMA NATHALY SR
Entity Type:Individual
Prefix:
First Name:ZORAIMA
Middle Name:NATHALY
Last Name:CHAVEZ
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 REEF WAY UNIT 11
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-1917
Mailing Address - Country:US
Mailing Address - Phone:407-675-9137
Mailing Address - Fax:
Practice Address - Street 1:1903 REEF WAY UNIT 11
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-1917
Practice Address - Country:US
Practice Address - Phone:407-675-9137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-18
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty