Provider Demographics
NPI:1134595879
Name:CHIN, DANIEL C (PA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:C
Last Name:CHIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1920 DON WICKHAM DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1918
Mailing Address - Country:US
Mailing Address - Phone:352-536-8761
Mailing Address - Fax:352-843-2120
Practice Address - Street 1:1920 DON WICKHAM DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1918
Practice Address - Country:US
Practice Address - Phone:352-536-8761
Practice Address - Fax:352-843-2120
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018936363AM0700X
FLPA9114405363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical