Provider Demographics
NPI:1356787832
Name:CHEN, KIR-WEI (MD)
Entity type:Individual
Prefix:
First Name:KIR-WEI
Middle Name:
Last Name:CHEN
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 1:5350 W HILLSBORO BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4396
Mailing Address - Country:US
Mailing Address - Phone:954-725-7660
Mailing Address - Fax:954-725-7605
Practice Address - Street 1:5350 W HILLSBORO BLVD STE 102
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073
Practice Address - Country:US
Practice Address - Phone:954-725-7660
Practice Address - Fax:954-725-7605
Is Sole Proprietor?:No
Enumeration Date:2013-05-11
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127523207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017123300Medicaid
FLIS833ZMedicare PIN