Individual
DR. KEITH W CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4620 N HABANA AVE, TAMPA, FL 33614-7107
(813) 875-9362
(813) 876-7055
Mailing address
4620 N HABANA AVE, SUITE 101, TAMPA, FL 33614-7107
(813) 875-9362
(813) 876-7055
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME38341
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME38341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065159100
—
FL
01
—
290004784
RAILROAD MEDICARE
FL
Enumeration date
07/27/2006
Last updated
06/21/2012
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