Provider Demographics
NPI:1477602068
Name:CHON, JOANNA K (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:K
Last Name:CHON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 PIPER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1449
Mailing Address - Country:US
Mailing Address - Phone:239-465-4157
Mailing Address - Fax:239-354-7603
Practice Address - Street 1:1035 PIPER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1449
Practice Address - Country:US
Practice Address - Phone:239-465-4157
Practice Address - Fax:239-354-7603
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112716208800000X, 2088F0040X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP1003924OtherFREEDOM
FLP959329OtherOPTIMUM
PA0018649820003Medicaid
FL355415OtherAVMED
FL005458100Medicaid
FL1641161OtherCIGNA
PA001864982003Medicaid
FL14KT9OtherBCBS FL
FL1192969OtherWELLCARE
FLP01054248OtherRAILROAD MEDICARE
FL0054581-00Medicaid
FL7326257OtherAETNA
FL005458100Medicaid
PA050886H8LMedicare PIN
FL7326257OtherAETNA
050886 HBLMedicare UPIN
PA0018649820003Medicaid