Provider Demographics
NPI:1184338022
Name:AHOLA, CHRIS E
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:E
Last Name:AHOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S ATLANTIC AVE APT C3
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-5901
Mailing Address - Country:US
Mailing Address - Phone:321-208-3301
Mailing Address - Fax:
Practice Address - Street 1:610 S ATLANTIC AVE APT C3
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-5901
Practice Address - Country:US
Practice Address - Phone:321-208-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL830533432374U00000X, 376J00000X, 376K00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide