Provider Demographics
NPI:1194409920
Name:CHRONIUS CARE MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:CHRONIUS CARE MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-253-6020
Mailing Address - Street 1:7901 4TH ST N STE 14102
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:813-280-0124
Mailing Address - Fax:833-974-1498
Practice Address - Street 1:12276 SAN JOSE BOULEVARD
Practice Address - Street 2:BUILDING 700, SUITE 722-8
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:813-280-0124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty