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General NPI Number Information
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NPI Number | 1932003506
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Entity Type | Organization
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Legal Business Name | CHASTITY CHYLD INCORPORATED
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 1487 2ND ST STE C3
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City | SARASOTA
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State | FL
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Zip | 34236-4911
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Country | US
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Telephone | 718-288-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 5265 UNIVERSITY PKWY # 101-189
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City | UNIVERSITY PARK
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State | FL
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Zip | 34201-3012
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Country | US
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Telephone | 718-288-8224
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NORTHERN STAR
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Credential | DR
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Telephone | 718-288-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | NULL
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