Provider Demographics
NPI:1770213993
Name:CHIN, SANDRA LILIANA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LILIANA
Last Name:CHIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LILIANA
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5824 STATE ROAD 54 STE 101
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-6061
Mailing Address - Country:US
Mailing Address - Phone:727-845-1933
Mailing Address - Fax:727-845-7307
Practice Address - Street 1:5824 STATE ROAD 54 STE 101
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-6061
Practice Address - Country:US
Practice Address - Phone:727-845-1933
Practice Address - Fax:727-845-7307
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF06220417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily