Individual
DR. KESHAN LAFAYE CHAMBLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5846 FELIX DR N, JACKSONVILLE, FL 32219-3809
(904) 334-3369
(904) 924-9907
Mailing address
5846 FELIX DR N, JACKSONVILLE, FL 32219-3809
(904) 334-3369
(904) 924-9907
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689237079
—
FL
05
—
689237096
—
FL
Enumeration date
04/08/2014
Last updated
04/08/2014
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