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General NPI Number Information
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NPI Number | 1679837280
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Entity Type | Organization
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Legal Business Name | CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 2230 NW 95TH ST
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City | MIAMI
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State | FL
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Zip | 33147-2414
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Country | US
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Telephone | 305-827-2977
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 PARK CENTRE BLVD #136
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City | MIAMI
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State | FL
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Zip | 33169-5373
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MARY CHEN
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Credential |
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Telephone | 305-628-6117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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