MEDICARE: DR. RAYMUND CHUA MD

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	ME 95592	FL

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	:	1821075532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMUND CHUA MD

Provider Business Mailing Address
First Line	:	906 MOONLUSTER DR
Second Line	:
City	:	CASSELBERRY
State	:	FL
Zip	:	32707-3437
Country	:	US
Telephone Number	:	407-637-5247
Fax Number	:

Provider Business Practice Location Address
First Line	:	5355 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4909
Country	:	US
Telephone Number	:	321-304-3300
Fax Number	:	321-304-3287

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	10/15/2012

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