Healthcare Provider Details

I. General information

NPI: 1497601181
Provider Name (Legal Business Name): CHANTENA ELIZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S KIRKMAN RD
ORLANDO FL
32819-7940
US

IV. Provider business mailing address

366 RED KITE DR
GROVELAND FL
34736-8010
US

V. Phone/Fax

Practice location:
  • Phone: 561-291-8597
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: