Healthcare Provider Details

I. General information

NPI: 1225561855
Provider Name (Legal Business Name): KAI CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

IV. Provider business mailing address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-7262
  • Fax:
Mailing address:
  • Phone: 407-767-7262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME144364
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME144364
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: