Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 11016559 | FL |
NPI | 1033876362 |
---|---|
Provider Name | Phillip A Chen |
First Address | Miami, FL 33179-3982 |
Second Address | Miami, FL 33179-3982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2021 |
Last Update Date | 22/11/2021 |