Basic Information
Provider Information
NPI: 1952486623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAMBERLIN
FirstName: ERIN
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22457 WEEKS BLVD
Address2:  
City: LAND O LAKES
State: FL
PostalCode: 346394683
CountryCode: US
TelephoneNumber: 8135463564
FaxNumber: 8139959444
Practice Location
Address1: 2727 W DR MARTIN LUTHER KING JR BLVD
Address2: SUITE 310
City: TAMPA
State: FL
PostalCode: 336076383
CountryCode: US
TelephoneNumber: 8133507244
FaxNumber: 8133507246
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 02/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X511659FLN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XME98107FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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