Healthcare Provider Details

I. General information

NPI: 1952693301
Provider Name (Legal Business Name): ELIZABETH TAN-CHIU MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N SUITE 114
BOCA RATON FL
33428-1762
US

IV. Provider business mailing address

7542 SAINT ANDREWS RD
LAKE WORTH FL
33467-1317
US

V. Phone/Fax

Practice location:
  • Phone: 954-582-1815
  • Fax: 954-582-1860
Mailing address:
  • Phone: 954-582-1815
  • Fax: 561-760-0265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME73690
License Number StateFL

VIII. Authorized Official

Name: DR. ELIZABETH TAN-CHIU
Title or Position: PHYSICIAN OWNER
Credential: M.D.
Phone: 954-582-1828