Healthcare Provider Details

I. General information

NPI: 1235759929
Provider Name (Legal Business Name): JAMIE CHIAPEI CHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 UNDERWOOD ST MP 153
ORLANDO FL
32806
US

IV. Provider business mailing address

505 CHATHAM AVE APT 357
ORLANDO FL
32801-0005
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-2558
  • Fax: 407-849-6470
Mailing address:
  • Phone: 352-665-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME174077
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: