Healthcare Provider Details

I. General information

NPI: 1134513724
Provider Name (Legal Business Name): MRS. CHAMAINE CINDY STOKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHAMAINE CINDY CHANCE RDMS

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6322 GONDOLA DR
RIVERVIEW FL
33578-1306
US

IV. Provider business mailing address

500 FAIRWAY DR STE 102
DEERFIELD BCH FL
33441-1817
US

V. Phone/Fax

Practice location:
  • Phone: 813-335-1649
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: