Chacon, Wanda Ivette

Chacon, Wanda Ivette is an individual health care provider with primary practice located at 2352 Bruce B Downs Blvd Ste 201 , Wesley Chapel FL 33544-9203. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Chacon, Wanda Ivette can be contacted via phone (813) 788-8160.

Contact Information

Primary practice address
2352 Bruce B Downs Blvd Ste 201 Wesley Chapel FL 33544-9203
Phone: (813) 788-8160
Fax: (813) 355-5065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN2894372 Florida
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN28943272 Florida

Profile Details

NPI number 1407226194
LBN Legal business name Chacon, Wanda Ivette
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2015
Last updated Jun 22nd, 2026 - about 5 months 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 1407226194 NPPES
Florida MEDICAID 021583900

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