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General NPI Number Information
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NPI Number | 1184925265
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Entity Type | Organization
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Legal Business Name | RICHARD L. CHANG PA
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 10820 SW 113TH PL
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City | MIAMI
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State | FL
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Zip | 33176-3227
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Country | US
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Telephone | 305-270-8083
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Fax | 305-271-5223
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Provider Business Mailing Address
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Address Line | 10820 SW 113TH PL
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City | MIAMI
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State | FL
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Zip | 33176-3227
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Country | US
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Telephone | 305-270-8083
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Fax | 305-271-5223
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Authorized Official
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Title or Position | MANAGER
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Name | S CHANG
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Credential |
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Telephone | 305-270-8083
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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 | ME 59505
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License Number State | FL
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