Organization
JEFFREY Y H CHUNG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA BEDOYA (CREDENTIALING MANAGER)
(727) 755-0693
Entity
Organization
Contact information
Practice address
14201 LAUREL PARK DR STE 104, LAUREL, MD 20707-5203
(727) 755-0693
Mailing address
311 PARK PLACE BLVD FL 5, CLEARWATER, FL 33759-4904
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
D67554
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418338000
—
MD
Enumeration date
03/29/2016
Last updated
03/29/2016
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