Provider Demographics
NPI:1225345234
Name:CHAMBERS, RONALD CHARLES JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:CHARLES
Last Name:CHAMBERS
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 E SUNRISE BLVD
Mailing Address - Street 2:SUITE 629
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1433
Mailing Address - Country:US
Mailing Address - Phone:954-627-0103
Mailing Address - Fax:
Practice Address - Street 1:1975 E SUNRISE BLVD
Practice Address - Street 2:SUITE 629
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1433
Practice Address - Country:US
Practice Address - Phone:954-627-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW2124104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker