MEDICARE: YOLAINE MARIE CHAMBLIN MD PA

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	261QP2300X	Primary Care Clinic/Center	ME 88893	FL

General Provider Information

NPI Number	:	1568497352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOLAINE MARIE CHAMBLIN MD PA

Provider Business Mailing Address
First Line	:	6785 BROOKLINE DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2441
Country	:	US
Telephone Number	:	305-200-1552
Fax Number	:	305-200-1552

Provider Business Practice Location Address
First Line	:	8910 MIRAMAR PKWY
Second Line	:	SUITE 110
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4100
Country	:	US
Telephone Number	:	954-442-6988
Fax Number	:	954-442-6202

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. YOLAINE MARIE CHAMBLIN
Credential	:	M.D.
Telephone Number	:	305-200-1552

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/13/2011

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