Chantina Wilson LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

CHANTINA WILSON LLC

Practice address

5126 Clover Mist Dr
Apollo Beach, FL 33572-3418

Phone

(813) 324-0180

NPI assigned

Mar 10, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chantina Wilson, WILSON

Title

Administrator

Phone

(813) 324-0180

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1861349896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 E FRIERSON AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336105124",
            "telephone_number": "813-324-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 CLOVER MIST DR",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335723418",
            "telephone_number": "813-324-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTINA WILSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHANTINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-324-0180",
        "authorized_official_credential": "WILSON"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.