Provider Demographics
NPI:1760867840
Name:CHANG MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CHANG MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-899-9739
Mailing Address - Street 1:8567 CORAL WAY
Mailing Address - Street 2:# 234
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2335
Mailing Address - Country:US
Mailing Address - Phone:786-899-9739
Mailing Address - Fax:305-468-6509
Practice Address - Street 1:8567 CORAL WAY
Practice Address - Street 2:# 234
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2335
Practice Address - Country:US
Practice Address - Phone:786-899-9739
Practice Address - Fax:305-468-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service