Provider Demographics
NPI:1700168085
Name:MBAKAYA-CHEN, PRAXIDES MUKOCHE (ARNP)
Entity type:Individual
Prefix:
First Name:PRAXIDES
Middle Name:MUKOCHE
Last Name:MBAKAYA-CHEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8901
Practice Address - Street 1:280 FARNER PL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-6066
Practice Address - Country:US
Practice Address - Phone:844-884-9355
Practice Address - Fax:352-674-8910
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9323763363L00000X
FLAPRN9323763363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004023800Medicaid
FK403ZOtherMEDICARE PTAN