MEDICARE: CHEYANNE LE'KAY CAUDILL CSA, CST

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
1	246ZC0007X	Surgical Assistant
2	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1164268728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYANNE LE'KAY CAUDILL CSA, CST

Provider Business Mailing Address
First Line	:	470 14TH ST SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-6576
Country	:	US
Telephone Number	:	772-643-2531
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 14TH ST SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-6576
Country	:	US
Telephone Number	:	772-643-2531
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	07/31/2025

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