Provider Demographics
NPI:1184607749
Name:CHEN, FENG (MD)
Entity type:Individual
Prefix:
First Name:FENG
Middle Name:
Last Name:CHEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1007
Mailing Address - Country:US
Mailing Address - Phone:954-430-3866
Mailing Address - Fax:954-422-1341
Practice Address - Street 1:601 N FLAMINGO RD STE 104
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1007
Practice Address - Country:US
Practice Address - Phone:954-430-3866
Practice Address - Fax:954-422-1341
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-5025207R00000X
FLME153631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2108909Medicaid
OH2108909Medicaid
OHG92383Medicare UPIN