MEDICARE: DR. CHASE DECUBELLIS D.C.

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	111N00000X	Chiropractor	CH10708	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1982950127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHASE DECUBELLIS D.C.

Provider Business Mailing Address
First Line	:	4115 LITTLE RD
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-1717
Country	:	US
Telephone Number	:	727-376-2024
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 LITTLE RD
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-1717
Country	:	US
Telephone Number	:	727-376-2024
Fax Number	:	727-376-2104

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

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	07/21/2022

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Directions to “ DR. CHASE DECUBELLIS D.C.” Practice Location

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