Provider Demographics
NPI:1730574898
Name:BARBULESCU, CHAUNCEY CALDWELL (MD)
Entity type:Individual
Prefix:
First Name:CHAUNCEY
Middle Name:CALDWELL
Last Name:BARBULESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10951 COUNTRYWAY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2630
Mailing Address - Country:US
Mailing Address - Phone:813-564-8993
Mailing Address - Fax:
Practice Address - Street 1:6331 MEMORIAL HWY STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4537
Practice Address - Country:US
Practice Address - Phone:813-882-9986
Practice Address - Fax:813-882-9849
Is Sole Proprietor?:No
Enumeration Date:2015-04-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME151363207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111093200Medicaid