Provider Demographics
NPI:1871062463
Name:CHAVEZ VIAMONTES, JOSE ANGEL (MS, RN, ARNP)
Entity type:Individual
Prefix:
First Name:JOSE ANGEL
Middle Name:
Last Name:CHAVEZ VIAMONTES
Suffix:
Gender:M
Credentials:MS, RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 NW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5347
Mailing Address - Country:US
Mailing Address - Phone:305-409-9120
Mailing Address - Fax:
Practice Address - Street 1:4425 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2800
Practice Address - Country:US
Practice Address - Phone:305-821-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9438123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily