Provider Demographics
NPI:1598772873
Name:CHEN, ALICIA (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:CHEN
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 1:4621 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2338
Mailing Address - Country:US
Mailing Address - Phone:850-741-4725
Mailing Address - Fax:850-741-4579
Practice Address - Street 1:4621 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2338
Practice Address - Country:US
Practice Address - Phone:850-741-4725
Practice Address - Fax:850-741-4579
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2593173-00Medicaid
FL2593173-00Medicaid
FL35558XMedicare ID - Type Unspecified