MEDICARE: CHAUNCEY CALDWELL BARBULESCU MD

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
1	207N00000X	Dermatology Physician	ME151363	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730574898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAUNCEY CALDWELL BARBULESCU MD

Provider Business Mailing Address
First Line	:	4004 S MACDILL AVE STE 2
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1551
Country	:	US
Telephone Number	:	813-709-8681
Fax Number	:	813-725-1611

Provider Business Practice Location Address
First Line	:	4004 S MACDILL AVE STE 2
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1551
Country	:	US
Telephone Number	:	813-709-8681
Fax Number	:	813-725-1611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2015
Last Update Date	:	04/08/2026

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