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General NPI Number Information
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NPI Number | 1861505463
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Entity Type | Individual
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Provider Name | JIAN-JUN CHEN MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 407 S WASHINGTON AVE SUITE 1
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City | TITUSVILLE
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State | FL
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Zip | 32796-3500
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Country | US
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Telephone | 321-385-0884
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Fax | 321-385-9578
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Provider Business Mailing Address
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Address Line | 407 S WASHINGTON AVE STE 1
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City | TITUSVILLE
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State | FL
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Zip | 32796-3500
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Country | US
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Telephone | 321-385-0884
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Fax | 321-385-9578
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME93471
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License Number State | FL
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