# ST.JOHN'S MEDICAL CLINIC,PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508166786
- **Authorized official:** DR. CHI-SHANG CHEN M.D (OWNER)
- **Authorized official phone:** (813) 972-1282

## Contact information

- **Practice address:** 12001 N NEBRASKA AVE, TAMPA, FL 33612-5343
- **Practice address phone:** (813) 972-1282
- **Practice address fax:** (813) 978-1677
- **Mailing address:** 12001 N NEBRASKA AVE, TAMPA, FL 33612-5343
- **Mailing address phone:** (813) 972-1282
- **Mailing address fax:** (813) 978-1677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME41425 | FL | Yes |

## Other

- **Enumeration date:** 10/22/2010
- **Last updated:** 10/22/2010