CHANDLER DIEDRICH (NPI# 1467917450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467917450 |
| Entity Type | Individual |
| Full Name | CHANDLER DIEDRICH |
| Credential | PA-C |
| Practice Address |
560 S Lakewood Dr Ste 101 Brandon FL 33511-5015 |
| Mailing Address |
13020 N Telecom Pkwy Temple Terrace FL 33637-0925 |
| Practice Telephone | 8139789700 |
| Mailing Telephone | 8139789700 |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2020-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9111892 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
560 S LAKEWOOD DR STE 101 |
| City | BRANDON |
| State | FL |
| Zip Code | 33511-5015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104853704 | Amanda Renea Porter | Physician Assistant | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5016 | 2006-06-27 |
| 1174158042 | Daniel Morgan Stuart | Specialist/Technologist | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5015 | 2020-03-11 |
| 1871134585 | Jordan Stone | Nurse Practitioner | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5015 | 2019-10-03 |
| 1699329375 | Cassandra Sunisa Turchany | Physician Assistant | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5015 | 2019-07-30 |
| 1023591674 | Annette M Frechette-lynn | Physician Assistant | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5016 | 2018-09-10 |
| 1144562448 | Evan Michael Loewy | Orthopaedic Surgery | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5015 | 2013-03-25 |
| 1750538906 | Musculoskeletal Institute Chartered | Clinic/Center | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5015 | 2008-08-19 |
| 1104091933 | Anjan R Shah | Orthopaedic Surgery | 560 S Lakewood Dr Ste 101, Brandon, FL 33511-5016 | 2008-04-23 |
| 1225191729 | Musculoskeletal Institute Chartered | Prosthetic/Orthotic Supplier | 560 S Lakewood Dr Ste 101, Brandon, FL 33511 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
| 1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
| 1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
| 1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
| 1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
| Find all providers in zip 33511 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568426906 | Anthony John Jimenez | Physician Assistant | 403 S Kings Ave Ste 201, Brandon, FL 33511-5962 | 2006-04-13 |
| 1922549104 | Kelly Cornnell | Physician Assistant | 305 E Brandon Blvd, Brandon, FL 33511-5222 | 2017-03-20 |
| 1639616865 | Katie Jameson | Physician Assistant | 305 E Brandon Blvd, Brandon, FL 33511-5222 | 2017-01-26 |
| 1134590391 | Adam Suchecki | Physician Assistant | 1007 Professional Park Dr, Brandon, FL 33511-4886 | 2015-10-14 |
| 1871975623 | Aaron Alexander Sookhoo | Physician Assistant | 500 Vonderburg Dr Ste 115w, Brandon, FL 33511-5969 | 2015-06-28 |
| 1043641467 | Alana Nicole Bulla | Physician Assistant | 270 S Moon Ave, Brandon, FL 33511-5711 | 2013-12-11 |
| 1619309614 | Kevin B Osborne | Physician Assistant | 305 E Brandon Blvd, Brandon, FL 33511-5222 | 2013-08-01 |
| 1275846115 | Amber R Strazzulla | Physician Assistant | 515 S Kings Ave Ste 3100, Brandon, FL 33511-6060 | 2010-07-21 |
| 1033209754 | Thomas Scott Gennara | Physician Assistant | 270 S Moon Ave, Brandon, FL 33511-5711 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
| 1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
| 1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
| 1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
| 1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
| 1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
| 1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
| 1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
| 1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHANDLER DIEDRICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.