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General NPI Number Information
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NPI Number | 1114241007
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Entity Type | Individual
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Provider Name | KRISTIN DIANNE CHAI M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2010
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 7875 W COMMERCIAL BLVD
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City | TAMARAC
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State | FL
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Zip | 33351-4353
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Country | US
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Telephone | 954-726-0099
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Fax | 954-726-0047
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Provider Business Mailing Address
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Address Line | 7875 W COMMERCIAL BLVD
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City | TAMARAC
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State | FL
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Zip | 33351-4353
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Country | US
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Telephone | 954-726-0099
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Fax | 954-726-0047
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME116299
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License Number State | FL
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