Basic Information
Provider Information
NPI: 1780723676
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAITIN
FirstName: BARBARA
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7111 FAIRWAY DR
Address2: SUITE 400
City: PALM BEACH GARDENS
State: FL
PostalCode: 334184204
CountryCode: US
TelephoneNumber: 8003306565
FaxNumber: 5617127349
Practice Location
Address1: 8150 CHANCELLOR DR
Address2: SUITE 110
City: ORLANDO
State: FL
PostalCode: 328097691
CountryCode: US
TelephoneNumber: 8003957284
FaxNumber: 4078562312
Other Information
ProviderEnumerationDate: 02/06/2007
LastUpdateDate: 10/16/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0101X158103NYN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZP0101XME99116FLY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology

No ID Information.


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