Individual
FLORDELIZA ABLAO-CHANTHAVICHITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3235 ACADEMY AVE, SUITE 305, PORTSMOUTH, VA 23703-3200
(757) 686-9300
(757) 686-1514
Mailing address
2876 GUARDIAN LN, VIRGINIA BEACH, VA 23452-7327
(757) 463-5240
(757) 463-6572
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024167161
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003968884
—
VA
Enumeration date
01/18/2007
Last updated
10/26/2007
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