Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME0035761 | FL |
NPI | 1033182803 |
---|---|
Provider Name | Dr. Joseph C Chan |
First Address | Miami Beach, FL 33140-2800 |
Second Address | Miami Beach, FL 33140-2800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D633695 | (02) | FL |