Healthcare Provider Details

I. General information

NPI: 1720258676
Provider Name (Legal Business Name): DR. CHRISTINE ANN CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 NW 4TH ST SUITE 200
PLANTATION FL
33317-2850
US

IV. Provider business mailing address

9468 SW 146TH PL
MIAMI FL
33186-1068
US

V. Phone/Fax

Practice location:
  • Phone: 954-791-5420
  • Fax:
Mailing address:
  • Phone: 305-388-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 98602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: