Provider Demographics
NPI:1376653881
Name:WIN, CHO MYA MON (MD)
Entity Type:Individual
Prefix:
First Name:CHO MYA MON
Middle Name:
Last Name:WIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4638 SUN N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2176
Mailing Address - Country:US
Mailing Address - Phone:863-386-0055
Mailing Address - Fax:
Practice Address - Street 1:4638 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2176
Practice Address - Country:US
Practice Address - Phone:863-386-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429620207R00000X, 208M00000X
FLME111988207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA34936OtherHEALTH PARTNERS FF
PA1900834OtherPERSONAL CHOICE
PA34935OtherHEALTH PARTNERS TC
PA1900834OtherHIGHMARK BLUE SHIELD
PA34937OtherHEALTH PARTNERS FB
PA1017561000002Medicaid
PA2767675000OtherKEYSTONE, IBC