Individual provider · Type 1 NPI
Simon Muttanil Chacko Jr., ARNP
Nurse Practitioner · Tampa, FL
Practice location
3117 W Gandy Blvd
Tampa, FL 33611-2927
Fax (702) 977-1496
Mailing address
PO Box 7410884
Chicago, IL 60674-0884
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | APRN9406548 (FL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
2 other providers at this address
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About NPI 1477782860
Simon Muttanil Chacko Jr., ARNP's National Provider Identifier is 1477782860, issued on Jul 7, 2009. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Tampa, FL. The record was last updated on Oct 3, 2025.