MEDICARE: CHINYERE CHRIS MBAERI M.D.

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	207Q00000X	Family Medicine Physician	ME101902	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912054297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINYERE CHRIS MBAERI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 212138
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33421-2138
Country	:	US
Telephone Number	:	561-623-0801
Fax Number	:	561-469-1928

Provider Business Practice Location Address
First Line	:	10111 FOREST HILL BLVD
Second Line	:	SUITE 320
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6108
Country	:	US
Telephone Number	:	561-623-0801
Fax Number	:	561-469-1928

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	05/23/2022

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