Provider Demographics
NPI:1881476828
Name:CHAPMAN, CAILIN MALINDA (PA-C)
Entity type:Individual
Prefix:
First Name:CAILIN
Middle Name:MALINDA
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 CYPRESS VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6834
Mailing Address - Country:US
Mailing Address - Phone:813-922-2660
Mailing Address - Fax:
Practice Address - Street 1:819 CYPRESS VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6834
Practice Address - Country:US
Practice Address - Phone:813-922-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2395133V00000X
FL12220133V00000X
FL9118004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered