Individual
CHANDLER MARDIS DEBARDELEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 214-4903
(321) 841-2196
Mailing address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 214-4903
(321) 841-2196
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN9467216
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11026371
FL
Other
Enumeration date
04/07/2021
Last updated
06/22/2023
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