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Deactivated NPI 1265432686 Deactivated / Inactive NPI Male Practitioner

Dr. Chowallur Dev Chacko , MD

Specialist • Orlando, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Chowallur Chacko has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 28, 2005
NPI Deactivation Date March 22, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Chowallur Chacko, MD was a registered Specialist practicing in Orlando, FL. Throughout an active medical career spanning 1 years, Dr. Chacko provided care at the practice location at 2718 N ORANGE AVE until profile deactivation on 2006-03-22.

Practice Location & Contact Primary Location

Practice Address

2718 N Orange Ave
Suite C

Orlando, FL 328047611

Telephone 4078942664
Fax 4078942450

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Orlando, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 40.0 Yrs
State Avg: 37.8 Yrs
Regional Practice Density
91 Specialists

Practicing in Orlando, FL (3036 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License FL ME0034022

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State License
ME0034022 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
NPI 1043480072

Doctor of Medicine (M.D.)

Dr. Tanvi Kamdar , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1164556312

Doctor of Medicine (M.D.)

NPI 1255535902

Doctor of Medicine (M.D.)

Dr. Thomas Wiswell , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1265476527

Doctor of Medicine (M.D.)

Dr. Lewis Otero , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1265476667

Doctor of Medicine (M.D.)

Sharon Craig , ARNP

Nurse Practitioner - Neonatal

NPI 1285713933

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 2718 N ORANGE AVE, SUITE C, ORLANDO, FL 328047611 (Tel: 4078942664)

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Updated Business Mailing Address July 08, 2007

Registered at 2718 N ORANGE AVE, SUITE C, ORLANDO, FL 328047611 (Tel: 4078942664)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CHOWALLUR CHACKO, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #ME0034022 in FL)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 22, 2006

Record deactivated on March 22, 2006

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Initial NPI Registration & Enumeration July 28, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265432686
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2005
Last Update: July 13, 2026
Deactivation Date: March 22, 2006
Sole Proprietor: No

Mailing Address

2718 N Orange Ave, Suite C

Orlando, FL 328047611

Phone: 4078942664

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.