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General NPI Number Information
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NPI Number | 1831539923
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Entity Type | Individual
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Provider Name | JASON CHEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 301 MEMORIAL MEDICAL PKWY
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5167
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Country | US
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Telephone | 386-231-3523
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Fax |
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Provider Business Mailing Address
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Address Line | 627 EMORY OAK CT
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City | KNOXVILLE
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State | TN
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Zip | 37909-3440
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Country | US
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Telephone | 214-714-5289
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME136426
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License Number State | FL
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