Provider Demographics
NPI:1366688020
Name:CHEN, MENGLAN (MD, AP)
Entity Type:Individual
Prefix:DR
First Name:MENGLAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 S VOLUSIA AVE STE C4
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7626
Mailing Address - Country:US
Mailing Address - Phone:407-690-7696
Mailing Address - Fax:
Practice Address - Street 1:2445 S VOLUSIA AVE STE C4
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7626
Practice Address - Country:US
Practice Address - Phone:407-690-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-029031207Q00000X
261QH0100X
FLAP1914171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service