Individual provider Active NPI

Carlos Chaban, MD

  • Pediatrics Physician
  • Apopka, FL
National Provider Identifier
1114078698
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME68094 Issued in FL
Practice address
425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428
Phone
(407) 786-4080
Fax
(407) 786-4667
NPI assigned
Jan 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME68094 FL Primary

Addresses

Primary practice location

425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428

Mailing address

425 S Hunt Club Blvd
Apopka, FL 32703-4947
Phone (407) 786-4080

Other practice location 1

737 Stirling Center Pl
Lake Mary, FL 32746-5715
Phone (407) 878-6008

Other identifiers 1

IdentifierTypeStateIssuer
263339600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME68094FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hunt Club Durable Medical Equipment LLC Current Accepting new patients
Huntclub Pediatric Associates, LLC Pediatrics PastSince Feb 11, 2024 Accepting new patients

Locations

425 S Hunt Club Blvd
Ste 1051
Apopka, FL 32703
Phone (407) 663-7566

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHAADD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1114078698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327034947",
            "telephone_number": "407-786-4080",
            "fax_number": "407-786-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 1051",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-786-4080",
            "fax_number": "407-786-4667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "737 Stirling Center Pl",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327465715",
            "country_code": "US",
            "telephone_number": "407-878-6008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHABAN",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME68094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263339600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.