Provider Demographics
NPI:1942248463
Name:JAMES F CHAMBLESS JR MD PA
Entity Type:Organization
Organization Name:JAMES F CHAMBLESS JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:CHAMBLESS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-267-2054
Mailing Address - Street 1:7500 SW 8TH ST
Mailing Address - Street 2:#308
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:305-267-2054
Mailing Address - Fax:305-267-0938
Practice Address - Street 1:7500 SW 8TH ST
Practice Address - Street 2:#308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:305-267-2054
Practice Address - Fax:305-267-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38089332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1305980001Medicare ID - Type Unspecified