Provider Demographics
NPI:1447427778
Name:CHICOYE, LORENA SHIRLEE (MD)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:SHIRLEE
Last Name:CHICOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3596 SW 143RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4704
Mailing Address - Country:US
Mailing Address - Phone:786-594-6470
Mailing Address - Fax:786-594-6233
Practice Address - Street 1:8500 SW 117TH RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4841
Practice Address - Country:US
Practice Address - Phone:786-594-6470
Practice Address - Fax:786-594-6233
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 80595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIF26824Medicare UPIN