Healthcare Provider Details

I. General information

NPI: 1437724309
Provider Name (Legal Business Name): CHASITY WHEELER HAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHASITY PAGES

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2803 JAMES L REDMAN PKWY STE 3
PLANT CITY FL
33566-9413
US

IV. Provider business mailing address

2803 JAMES L REDMAN PKWY STE 3
PLANT CITY FL
33566-9413
US

V. Phone/Fax

Practice location:
  • Phone: 813-754-3955
  • Fax:
Mailing address:
  • Phone: 813-754-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: