Provider Demographics
NPI:1528595980
Name:BOBOLA, CHELSEA (PTA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BOBOLA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 N ALAFAYA TRL APT 59
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3954
Mailing Address - Country:US
Mailing Address - Phone:407-443-6185
Mailing Address - Fax:
Practice Address - Street 1:2531 N ALAFAYA TRL APT 59
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3954
Practice Address - Country:US
Practice Address - Phone:407-443-6185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26635208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation