Provider Demographics
NPI:1154131175
Name:CHAVEZ RODRIGUEZ, JOHANY ARYNE (FNP-C)
Entity type:Individual
Prefix:
First Name:JOHANY
Middle Name:ARYNE
Last Name:CHAVEZ RODRIGUEZ
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:JOHANY
Other - Middle Name:
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2047 SUNNY DALE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8325 UNIVERSITY PKWY STE A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-4949
Practice Address - Country:US
Practice Address - Phone:850-324-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP003428363LF0000X
FLAPRN11037562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty