CHELSEA JO LILES (NPI# 1467963629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467963629 |
| Entity Type | Individual |
| Full Name | CHELSEA JO LILES |
| Credential | PA-C |
| Practice Address |
309 N Mangoustine Ave Unit G Sanford FL 32771-1098 |
| Mailing Address |
Po Box 370 Fortson GA 31808-0370 |
| Practice Telephone | 3213631754 |
| Practice Fax Number | 3213633336 |
| Mailing Telephone | 7064943071 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2020-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9112179 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 Illini Dr, Silvis, IL 612821804 | 3092814000 | |
| 819 E Oak St Ste A, Kissimmee, FL 34744 | 4074760780 | 4074760785 |
| Street Address |
309 N MANGOUSTINE AVE UNIT G |
| City | SANFORD |
| State | FL |
| Zip Code | 32771-1098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952374498 | Samuel G. Agnew | Orthopaedic Surgery | 309 N Mangoustine Ave Unit G, Sanford, FL 32771-1098 | 2006-02-07 |
| 1487130571 | Hughston Clinic Southeast PC | Durable Medical Equipment & Medical Supplies | 309 N Mangoustine Ave Unit G, Sanford, FL 32771-1098 | 2018-07-12 |
| 1902867468 | Anthony Michael Harris | Orthopaedic Surgery | 309 N Mangoustine Ave Unit G, Sanford, FL 32771-1098 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134695224 | Sheena L Grayson | Pharmacist | 4942 W State Rd 46, Suite 1014, Sanford, FL 32771 | 2018-10-16 |
| 1699284299 | Christopher Ryan King | Chiropractor | 1026 Old England Loop, Sanford, FL 32771 | 2017-09-26 |
| 1669991345 | Scarlett Sierra | Counselor | 401 W Seminole Blvd, Sanford, FL 32771 | 2017-09-14 |
| 1881132249 | Tracy Shibla | Nurse Practitioner | 2320 Retreat View Cir, Sanford, FL 32771 | 2017-02-06 |
| 1205387206 | Tabitha Boyd | Behavior Technician | 4136 Geranium Ln #102, Sanford, FL 32771 | 2016-10-14 |
| 1104275874 | Jessica Willis | Nurse Anesthetist, Certified Registered | 108 Temple Dr, Sanford, FL 32771 | 2016-06-03 |
| 1013379957 | Bai Medical LLC | Point of Service | 580 Lexington Green Lane, Sanford, FL 32771 | 2016-03-21 |
| 1710347851 | Melissa T Ramsawak | Nurse Practitioner | 4930 East Lake Mary Boulevard, Sanford, FL 32771 | 2016-03-02 |
| 1811394570 | Tanesha Burns | Counselor | 209 San Carlos Ave Ste 111a, Sanford, FL 32771 | 2014-11-24 |
| 1053717322 | Amy Hertz, Dmd and Minta Lopez-torres, Dmd | Dentist | 5030 West Sr 46, Suite 1018, Sanford, FL 32771 | 2014-11-13 |
| Find all providers in zip 32771 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| 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 | ||||
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| 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.