Provider Demographics
NPI:1881887669
Name:ARAGONA CHINCHAR, CAROL (PTA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ARAGONA CHINCHAR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3472 S WINDING PATH
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-7518
Mailing Address - Country:US
Mailing Address - Phone:352-678-8486
Mailing Address - Fax:
Practice Address - Street 1:3472 S WINDING PATH
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-7518
Practice Address - Country:US
Practice Address - Phone:352-678-8486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1002593225200000X
FL20473225200000X
PATE007969225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20473OtherPHYSICAL THERAPY ASSISTAN
PATE1002593OtherPTA