Provider Demographics
NPI:1285930297
Name:DELLE CHIAIE, BRANDON CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:CHRISTOPHER
Last Name:DELLE CHIAIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 CANDLELIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-3116
Mailing Address - Country:US
Mailing Address - Phone:352-796-2660
Mailing Address - Fax:352-799-4487
Practice Address - Street 1:934 CANDLELIGHT BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3116
Practice Address - Country:US
Practice Address - Phone:352-796-2660
Practice Address - Fax:352-799-4487
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEY599ZMedicare UPIN