Healthcare Provider Details

I. General information

NPI: 1346168101
Provider Name (Legal Business Name): RANY CHACKO VARGHESE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34194 RADLEY WAY
WESLEY CHAPEL FL
33545-2155
US

IV. Provider business mailing address

34194 RADLEY WAY
WESLEY CHAPEL FL
33545-2155
US

V. Phone/Fax

Practice location:
  • Phone: 407-607-2013
  • Fax:
Mailing address:
  • Phone: 407-607-2013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048339
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: