Chanun Park DO PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OS8128 Issued in FL

Legal business name

CHANUN PARK DO PA

Practice address

1220 Business Way
Unit 1
Lehigh Acres, FL 33936-6007

Phone

(239) 369-4155

Fax

(239) 369-1950

NPI assigned

Sep 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Chanun Dustin Park, D.O.

Title

President

Phone

(239) 369-4155

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1619126323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 BUSINESS WAY",
            "address_2": "UNIT 1",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366007",
            "telephone_number": "239-369-4155",
            "fax_number": "239-369-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 BUSINESS WAY",
            "address_2": "UNIT 1",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366007",
            "telephone_number": "239-369-4155",
            "fax_number": "239-369-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANUN PARK DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHANUN",
        "authorized_official_middle_name": "DUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-369-4155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS8128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leyanis Cespedes Henriquez
• Sini Chacko, RN
• Tony Chan, PA-C
• Guillermo S Chang Licea, APRN
• Gissel Chang
• Ada Charleus
• Yaneisi Chaviano
• Deborah Louise Chenoweth, RPH
• Childrens ABA Services, LLC
• Childrens Behavioral Rehab LLC

• Primary Care Clinic/Center in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.