MEDICARE: FLORIDA MH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306505805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA MH LLC

Provider Business Mailing Address
First Line	:	7488 COURTYARD RUN E
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 S FEDERAL HWY STE 215
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-7404
Country	:	US
Telephone Number	:	561-331-1722
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SI ARTHUR CHEN
Credential	:	PSYD
Telephone Number	:	561-331-1722

Provider Enumeration Date	:	12/12/2021
Last Update Date	:	12/12/2021

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Directions to “FLORIDA MH LLC ” Practice Location

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