Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | ME107346 | FL |
NPI | 1093974420 |
---|---|
Provider Name | Dr. Jerome Gene Chen |
First Address | Orlando, FL 32806-2032 |
Second Address | Orlando, FL 32806-2032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 21/07/2011 |