Provider Demographics
NPI:1912581653
Name:CHMA OF FL LLC
Entity Type:Organization
Organization Name:CHMA OF FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WELIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-383-9300
Mailing Address - Street 1:909 RIDGEBROOK RD STE 300NA
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9474
Mailing Address - Country:US
Mailing Address - Phone:443-383-9300
Mailing Address - Fax:
Practice Address - Street 1:2875 NE 191ST ST STE 500
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2832
Practice Address - Country:US
Practice Address - Phone:443-383-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty