MEDICARE: MR. VICTOR J CHIN AP

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	171100000X	Acupuncturist	AP000199	FL
2	171100000X	Acupuncturist	AP0000099	FL
3	225100000X	Physical Therapist	PT0002038	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C0083	OTHER		BCBS
2	C0096	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1285840066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VICTOR J CHIN AP

Provider Business Mailing Address
First Line	:	5401 COLLINS AVE
Second Line	:	# CU12
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2573
Country	:	US
Telephone Number	:	305-866-6911
Fax Number	:	305-864-1274

Provider Business Practice Location Address
First Line	:	5401 COLLINS AVE
Second Line	:	# CU12
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2573
Country	:	US
Telephone Number	:	305-866-6911
Fax Number	:	305-864-1274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	01/16/2013

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