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NPI Code Detail

MEDICARE: CHASTITY WASHINGTON

MEDICARE: CHASTITY WASHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1154766517
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASTITY WASHINGTON
Provider Business Mailing Address
First Line : 1315 W WASHINGTON ST
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-5039
Country : US
Telephone Number : 813-490-5490
Fax Number :
Provider Business Practice Location Address
First Line : 1315 W WASHINGTON ST
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-5039
Country : US
Telephone Number : 813-490-5490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2013
Last Update Date : 04/30/2013

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Directions to “ CHASTITY WASHINGTON ” Practice Location

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