Individual
NICOLE CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 5TH ST S, DEPARTMENT 70-6600, ST PETERSBURG, FL 33701
(727) 767-4170
(727) 767-4346
Mailing address
601 5TH ST S, DEPARTMENT 70-6600, ST PETERSBURG, FL 33701
(727) 767-4170
(727) 767-4346
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
D0064535
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000191600
—
FL
Enumeration date
01/29/2007
Last updated
10/04/2010
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