Provider Demographics
NPI:1831583350
Name:CHANDLER, CECILIA LETICIA (APRN)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:LETICIA
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9048 109TH TERRACE NORTH
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777
Mailing Address - Country:US
Mailing Address - Phone:727-324-7263
Mailing Address - Fax:
Practice Address - Street 1:6735 CROSSWINDS DR N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5471
Practice Address - Country:US
Practice Address - Phone:727-548-8500
Practice Address - Fax:727-501-7328
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9315356363LF0000X
FLARNP9315356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1560364OtherWELLMED
FL7HD1WOtherFLORIDA BLUE
FL023874000Medicaid
FL6599258OtherAETNA
FL375742OtherUNITED
FL1535616OtherCIGNA