Healthcare Provider Details

I. General information

NPI: 1205814852
Provider Name (Legal Business Name): CHEN-SIEN HU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 LITTLE RD SUITE 104
TRINITY FL
34655-1815
US

IV. Provider business mailing address

3633 LITTLE RD SUITE 104
TRINITY FL
34655-1815
US

V. Phone/Fax

Practice location:
  • Phone: 727-845-1406
  • Fax: 727-847-0489
Mailing address:
  • Phone: 727-845-1406
  • Fax: 727-847-0489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME 0044174
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: