Provider Demographics
NPI:1417589151
Name:MILES, CHAKAIA
Entity type:Individual
Prefix:MS
First Name:CHAKAIA
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N MLK JR AVE APT 1203
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-3334
Mailing Address - Country:US
Mailing Address - Phone:248-390-5199
Mailing Address - Fax:
Practice Address - Street 1:1001 N MLK JR AVE APT 1203
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-3334
Practice Address - Country:US
Practice Address - Phone:248-390-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer