Provider Demographics
NPI:1972726842
Name:DR SON L CHAU PA
Entity Type:Organization
Organization Name:DR SON L CHAU PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-273-9410
Mailing Address - Street 1:1287 N SEMORAN BLVD
Mailing Address - Street 2:200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1287 N SEMORAN BLVD
Practice Address - Street 2:200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3534
Practice Address - Country:US
Practice Address - Phone:407-273-9410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3006Medicare PIN