Individual ProviderAlvin ChackungalNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address12182 SW 122nd Ct, Miami, FL 33186-9025(305) 967-0066PECOS EnrollmentBased on the most recent information from CMS, provider Alvin Chackungal does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1407530447Provider TypeIndividualFull NameChackungal, AlvinGenderMaleSole ProprietorYesEnumeration Date6/12/2023Last Updated12/8/2025Contact InformationPractice LocationPractice Address12182 SW 122nd Ct, Miami, FL 33186-9025Phone(305) 967-0066FaxUnlisted FaxMailing LocationMailing Address12182 SW 122nd Ct, Miami, FL 33186-9025Phone(305) 967-0066FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11033611FloridaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense9480539Florida