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General NPI Number Information
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NPI Number | 1003168451
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Entity Type | Organization
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Legal Business Name | JAY S. CHANDAR, MD, PA
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 3850 HOLLYWOOD BLVD SUITE 202
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6700
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Country | US
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Telephone | 954-894-4115
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Fax | 954-894-2116
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Provider Business Mailing Address
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Address Line | 3850 HOLLYWOOD BLVD SUITE 202
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6700
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Country | US
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Telephone | 954-894-4115
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Fax | 954-894-2116
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAY S. CHANDAR
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Credential | M.D.,
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Telephone | 954-894-4115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | ME50375
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License Number State | FL
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