Healthcare Provider Details

I. General information

NPI: 1306700372
Provider Name (Legal Business Name): CHEDLER JOSEPH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12266 NW 57TH ST
CORAL SPRINGS FL
33076-3649
US

IV. Provider business mailing address

12266 NW 57TH ST
CORAL SPRINGS FL
33076-3649
US

V. Phone/Fax

Practice location:
  • Phone: 954-709-9372
  • Fax:
Mailing address:
  • Phone: 954-709-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11041300
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: