Provider Demographics
NPI:1720293129
Name:CHONOLES, JEAN (PA)
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:
Last Name:CHONOLES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 6TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-9010
Mailing Address - Country:US
Mailing Address - Phone:239-353-9735
Mailing Address - Fax:
Practice Address - Street 1:4867 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6953
Practice Address - Country:US
Practice Address - Phone:239-234-5623
Practice Address - Fax:239-234-5624
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL2209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant