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General NPI Number Information
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NPI Number | 1023046521
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Entity Type | Individual
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Provider Name | KINGSLEY R CHIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 3816 HOLLYWOOD BLVD STE 102
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6750
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Country | US
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Telephone | 954-640-6010
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Fax | 855-411-4647
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Provider Business Mailing Address
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Address Line | 1100 W OAKLAND PARK BLVD SUITE #3
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City | WILTON MANORS
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State | FL
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Zip | 33311-1612
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Country | US
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Telephone | 561-822-2960
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Fax | 877-647-7874
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA10203200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME90952
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License Number State | FL
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