Healthcare Provider Details

I. General information

NPI: 1003727397
Provider Name (Legal Business Name): CHELSEA EUNHAE HAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 CANOPY ESTATES DR
WINTER GARDEN FL
34787-5094
US

IV. Provider business mailing address

641 CANOPY ESTATES DR
WINTER GARDEN FL
34787-5094
US

V. Phone/Fax

Practice location:
  • Phone: 407-399-1466
  • Fax:
Mailing address:
  • Phone: 407-399-1466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: