Individual
CHANTALE VIXAMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10184 SOUTHERN PRIDE PL, WELLINGTON, FL 33449-8007
(561) 904-1363
Mailing address
10184 SOUTHERN PRIDE PL, WELLINGTON, FL 33449-8007
(561) 904-1363
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11016889
FL
Other
Enumeration date
02/05/2022
Last updated
02/05/2022
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