Individual
CHANEL MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1019 WYNNMERE WALK AVE, RUSKIN, FL 33570-2067
(347) 982-7572
Mailing address
1019 WYNNMERE WALK AVE, RUSKIN, FL 33570-2067
(347) 982-7572
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11040421
FL
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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