Healthcare Provider Details

I. General information

NPI: 1306757547
Provider Name (Legal Business Name): JADYN MARCEIL CHANDLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 12TH AVE
MIAMI FL
33136-1087
US

IV. Provider business mailing address

6900 SW 44TH ST APT 206
MIAMI FL
33155-4768
US

V. Phone/Fax

Practice location:
  • Phone: 305-689-5635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number43486
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: