Provider Demographics
NPI:1497423693
Name:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Entity Type:Organization
Organization Name:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-628-6117
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:305-628-6117
Mailing Address - Fax:
Practice Address - Street 1:401 OPA LOCKA BLVD
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3528
Practice Address - Country:US
Practice Address - Phone:786-535-7200
Practice Address - Fax:786-535-7294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site