| Entity Name: | ARCENIO CHACON, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Aug 1993 (31 years ago) |
| Document Number: | P93000060170 |
| FEI/EIN Number | 65-0435406 |
| Address: | 5790 SW 91 St, MIAMI, FL, 33156, US |
| Mail Address: | P.O. BOX 565580, MIAMI, FL, 33256 |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255493375 | 2006-12-14 | 2020-08-22 | 10845 SW 62ND AVE, MIAMI, FL, 331564022, US | 8900 N KENDALL DR, MIAMI, FL, 331762118, US | |||||||||||||||
|
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| Phone | +1 786-596-5387 |
| Fax | 7862758403 |
Authorized person
| Name | ARCENIO CHACON III |
| Role | OWNER |
| Phone | 7865965387 |
Taxonomy
| Taxonomy Code | 2080P0203X - Pediatric Critical Care Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHACON ARCENIO M | Agent | 5790 SW 91 St, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| CHACON ARCENIO M | Director | 5790 SW 91 St, MIAMI, FL, 33156 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
