Provider Demographics
NPI:1982950127
Name:DECUBELLIS, CHASE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:
Last Name:DECUBELLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1717
Mailing Address - Country:US
Mailing Address - Phone:727-376-2024
Mailing Address - Fax:
Practice Address - Street 1:4115 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1717
Practice Address - Country:US
Practice Address - Phone:727-376-2024
Practice Address - Fax:727-376-2104
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor