Provider Demographics
NPI:1255379186
Name:CHION-FONG, FELIX (MD)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:CHION-FONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9732 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7513
Mailing Address - Country:US
Mailing Address - Phone:305-221-0660
Mailing Address - Fax:305-221-0696
Practice Address - Street 1:9732 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7513
Practice Address - Country:US
Practice Address - Phone:305-221-0660
Practice Address - Fax:305-221-0696
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68838208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014865200Medicaid