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NPI Code Detail

MEDICARE: KELLI CHANDLER OTR/L

MEDICARE: KELLI CHANDLER OTR/L
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
1225X00000XOccupational TherapistOT 14064FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285950980
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI CHANDLER OTR/L
Provider Business Mailing Address
First Line : 2731 VICTORIAN OAKS DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-1865
Country : US
Telephone Number : 904-707-5875
Fax Number :
Provider Business Practice Location Address
First Line : 9000 SOUTHSIDE BLVD BLDG 900
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-0791
Country : US
Telephone Number : 904-732-4343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2010
Last Update Date : 09/20/2022

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Directions to “ KELLI CHANDLER OTR/L” Practice Location

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