Provider Demographics
NPI:1205600939
Name:RIZZARDI, CHANTEL LESLE (CNA)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:LESLE
Last Name:RIZZARDI
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358241
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-8241
Mailing Address - Country:US
Mailing Address - Phone:863-381-1657
Mailing Address - Fax:
Practice Address - Street 1:9200 NW 39TH AVE STE 130-3322
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7331
Practice Address - Country:US
Practice Address - Phone:863-381-1657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL582683146D00000X
FL428970376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant