MEDICARE: CHIANG SIU INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1093876120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIANG SIU INC

Provider Business Mailing Address
First Line	:	20 PORTA VISTA CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-5802
Country	:	US
Telephone Number	:	561-627-9804
Fax Number	:	561-627-2556

Provider Business Practice Location Address
First Line	:	20 PORTA VISTA CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-5802
Country	:	US
Telephone Number	:	561-627-9804
Fax Number	:	561-627-2556

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ORLANDO CHIANG
Credential	:	P.T.
Telephone Number	:	561-627-9804

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/22/2020

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