Provider Demographics
NPI:1982651816
Name:CHAMBLESS, JAMES FRED JR (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FRED
Last Name:CHAMBLESS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 SW 8TH STREET
Mailing Address - Street 2:SUITE #308
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:305-267-2054
Mailing Address - Fax:305-267-0938
Practice Address - Street 1:7500 SW 8TH STREET
Practice Address - Street 2:SUITE #308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:305-267-2054
Practice Address - Fax:305-267-0938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11661207R00000X
FLME38089207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94425Medicare ID - Type Unspecified
D64700Medicare UPIN