Healthcare Provider Details

I. General information

NPI: 1104517143
Provider Name (Legal Business Name): CHASE JAMES CERBONE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N FLAGLER DR STE 360
WEST PALM BEACH FL
33401-3429
US

IV. Provider business mailing address

298 SW VISTA LAKE DR
PORT SAINT LUCIE FL
34953-8233
US

V. Phone/Fax

Practice location:
  • Phone: 561-659-1688
  • Fax:
Mailing address:
  • Phone: 561-319-7209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27878
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: