Provider Demographics
NPI:1306171749
Name:CHINEA, IGNACIO C (MD)
Entity type:Individual
Prefix:
First Name:IGNACIO
Middle Name:C
Last Name:CHINEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 NW 42ND AVE
Mailing Address - Street 2:FL 5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:305-504-7885
Mailing Address - Fax:
Practice Address - Street 1:61 GRAND CANAL DR STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2554
Practice Address - Country:US
Practice Address - Phone:305-563-2189
Practice Address - Fax:305-367-8358
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR27455207R00000X
FLME112868207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME112868OtherME