Provider Demographics
NPI:1730438854
Name:CHAKOFF, ELISSA ANDREA (MED, EDS)
Entity type:Individual
Prefix:
First Name:ELISSA
Middle Name:ANDREA
Last Name:CHAKOFF
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MIAMI AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1617
Mailing Address - Country:US
Mailing Address - Phone:305-577-9000
Mailing Address - Fax:
Practice Address - Street 1:155 S MIAMI AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1617
Practice Address - Country:US
Practice Address - Phone:305-577-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist