Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO 2394 | FL |
NPI | 1225091598 |
---|---|
Provider Name | Dr. David S Chen |
First Address | Tamarac, FL 33321-2953 |
Second Address | Tamarac, FL 33321-2953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 11/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U30658 | (02) | FL |