Healthcare Provider Details

I. General information

NPI: 1972973485
Provider Name (Legal Business Name): THOMAS EUGENE CHAMBERS SR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 11/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 QUIET FOREST TRL
CHULUOTA FL
32766-9176
US

IV. Provider business mailing address

1800 QUIET FOREST TRL
CHULUOTA FL
32766-9176
US

V. Phone/Fax

Practice location:
  • Phone: 407-399-7014
  • Fax:
Mailing address:
  • Phone: 407-399-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS 1530
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: