Healthcare Provider Details

I. General information

NPI: 1760452957
Provider Name (Legal Business Name): LAWRENCE CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 68TH ST EMERGENCY DEPARTMENT
HIALEAH FL
33016-1801
US

IV. Provider business mailing address

PO BOX 534235
ATLANTA GA
30353-4235
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-5000
  • Fax: 904-346-0113
Mailing address:
  • Phone: 305-651-2270
  • Fax: 904-346-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0090076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: