MEDICARE: S ANNETTE CHANCE DO

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	207Q00000X	Family Medicine Physician	3598	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336100395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	S ANNETTE CHANCE DO

Provider Business Mailing Address
First Line	:	9325 GLADES RD STE 104
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-3988
Country	:	US
Telephone Number	:	561-620-7779
Fax Number	:	561-367-9509

Provider Business Practice Location Address
First Line	:	9325 GLADES RD STE 104
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-3988
Country	:	US
Telephone Number	:	561-620-7779
Fax Number	:	561-367-9509

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	07/08/2007

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Directions to “ S ANNETTE CHANCE DO” Practice Location

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