Provider Demographics
NPI:1558491886
Name:CHANDLER, ELIZABETH J (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:305 MEMORIAL MEDICAL PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5169
Mailing Address - Country:US
Mailing Address - Phone:386-231-3460
Mailing Address - Fax:
Practice Address - Street 1:2 PINE LAKES PKWY N STE 3
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3644
Practice Address - Country:US
Practice Address - Phone:386-264-6036
Practice Address - Fax:386-264-6037
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2526452081P2900X
FLME1028292081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine