Provider Demographics
NPI:1770886095
Name:COLAS, CHANCILENE (ARNP)
Entity type:Individual
Prefix:
First Name:CHANCILENE
Middle Name:
Last Name:COLAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S PINE ISLAND RD STE 375
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2667
Mailing Address - Country:US
Mailing Address - Phone:954-588-1146
Mailing Address - Fax:
Practice Address - Street 1:150 S PINE ISLAND RD STE 375
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2667
Practice Address - Country:US
Practice Address - Phone:954-588-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2899962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily