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General NPI Number Information
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NPI Number | 1669265617
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Entity Type | Individual
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Provider Name | CHANTE MCKIE
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Gender | Female
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 14320 BRUCE B DOWNS BLVD
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City | TAMPA
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State | FL
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Zip | 33613-2601
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Country | US
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Telephone | 813-280-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 2281 NW 33RD AVE
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311-2728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9120535
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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