Provider Demographics
NPI:1396934568
Name:CHIARELLI, CHRISTIAN J (PA)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:J
Last Name:CHIARELLI
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13590 JOG RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3807
Mailing Address - Country:US
Mailing Address - Phone:561-637-4200
Mailing Address - Fax:
Practice Address - Street 1:13590 JOG RD
Practice Address - Street 2:SUITE 7
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3807
Practice Address - Country:US
Practice Address - Phone:561-637-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9104332363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical