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General NPI Number Information
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NPI Number | 1326018391
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Entity Type | Individual
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Provider Name | LEO C CHEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 339 RACETRACK RD NW SUITE 12
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1538
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Country | US
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Telephone | 850-864-3339
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Fax | 850-864-1715
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Provider Business Mailing Address
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Address Line | 339 RACETRACK RD NW SUITE 12
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1538
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Country | US
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Telephone | 850-864-3339
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Fax | 850-864-1715
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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 | ME86347
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License Number State | FL
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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 | K5484
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 054597
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4940494-1205
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License Number State | UT
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