Provider Demographics
NPI:1780791640
Name:CHASE, ANTHONY
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CHASE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 ROCK CREEK ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5788
Mailing Address - Country:US
Mailing Address - Phone:407-451-5501
Mailing Address - Fax:407-605-0699
Practice Address - Street 1:974 ROCK CREEK ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-5788
Practice Address - Country:US
Practice Address - Phone:407-451-5501
Practice Address - Fax:407-605-0699
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11507OtherLICENSE #