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General NPI Number Information
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NPI Number | 1306057419
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Entity Type | Individual
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Provider Name | JENNIFER ROSE CHAPMAN-FREDRICKS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-6044
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Fax |
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Provider Business Mailing Address
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Address Line | 969 NE 92ND ST
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2910
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Country | US
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Telephone | 954-415-2488
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Fax |
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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 | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | ME103429
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License Number State | FL
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