MEDICARE: DR. CHAIM HYMAN DMD

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	122300000X	Dentist	16366	FL
2	1223G0001X	General Practice Dentistry	16925	FL

General Provider Information

NPI Number	:	1912051566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAIM HYMAN DMD

Provider Business Mailing Address
First Line	:	1327 PROVIDENCE RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4885
Country	:	US
Telephone Number	:	813-662-4848
Fax Number	:	813-315-6373

Provider Business Practice Location Address
First Line	:	1327 PROVIDENCE RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4885
Country	:	US
Telephone Number	:	813-662-4848
Fax Number	:	813-315-6373

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	12/05/2011

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