CHARMELENE CHANTHABOUASITH

TAMPA, FL
NPI1750751772
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA9108932)
Enumeration Date2015-10-02
Last Update Date2019-08-01
Business Address
CHARMELENE CHANTHABOUASITH
4278 W LINEBAUGH AVE
TAMPA, FL 33624-5241
Phone number: 813-977-0733
Mailing Address
CHARMELENE CHANTHABOUASITH
4278 W LINEBAUGH AVE
TAMPA, FL 33624-5241
Phone number: 813-977-0733
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