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General NPI Number Information
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NPI Number | 1831145200
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Entity Type | Organization
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Legal Business Name | JOSEPH J CHANDA MD PA
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 207 SILVER PALM AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-3143
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Country | US
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Telephone | 321-724-4010
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Fax | 321-722-0442
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Provider Business Mailing Address
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Address Line | 207 SILVER PALM AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-3143
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Country | US
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Telephone | 321-724-4010
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Fax | 321-722-0442
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH JOHN CHANDA
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Credential | M.D.
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Telephone | 321-724-4010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | ME32634
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License Number State | FL
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