Ablao-Chanthavichith, Flordeliza

Ablao-Chanthavichith, Flordeliza is an individual health care provider with primary practice located at 3235 Academy Ave Suite 305, Portsmouth VA 23703-3200. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Ablao-Chanthavichith, Flordeliza can be contacted via phone (757) 686-9300.

Contact Information

Primary practice address
3235 Academy Ave Suite 305 Portsmouth VA 23703-3200
Phone: (757) 686-9300
Fax: (757) 686-1514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024167161 Virginia

Profile Details

NPI number 1003968884
LBN Legal business name Ablao-Chanthavichith, Flordeliza
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Oct 26th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003968884 NPPES
Virginia MEDICAID 1003968884

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