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NPI Code Detail

MEDICARE: CHELSEA R NAGEL

MEDICARE: CHELSEA R NAGEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior AnalystFL

General Provider Information

NPI Number : 1679190631
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA R NAGEL
Provider Business Mailing Address
First Line : 12514 BALLENTRAE FOREST DR
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-9338
Country : US
Telephone Number : 772-341-3119
Fax Number :
Provider Business Practice Location Address
First Line : 14497 N DALE MABRY HWY STE 115N
Second Line :
City : TAMPA
State : FL
Zip : 33618-2023
Country : US
Telephone Number : 813-814-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2020
Last Update Date : 01/17/2023

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Directions to “ CHELSEA R NAGEL ” Practice Location

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