Healthcare Provider Details

I. General information

NPI: 1851688295
Provider Name (Legal Business Name): JENNY CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 SW 34TH CIR SUITE 101
OCALA FL
34474-3358
US

IV. Provider business mailing address

4881 NW 8TH AVE STE 2 SUITE 100
GAINESVILLE FL
32605-4582
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-7575
  • Fax: 352-401-7577
Mailing address:
  • Phone: 352-401-7575
  • Fax: 352-401-7577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME120738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: