Basic Information
| Provider Information | |||||||||
| NPI: | 1457818965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHIOSSONE KERDEL | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | ARMANDO ANT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1120 NW 14TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052433564 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8100 SW 10TH ST | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542101141 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2019 | ||||||||
| LastUpdateDate: | 03/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MFC1817 | FL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.