Individual
COLIN CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12450 ROOSEVELT BLVD N, SUITE 101, ST PETERSBURG, FL 33716-1902
(727) 571-1688
(727) 572-0900
Mailing address
12450 ROOSEVELT BLVD N STE 101, ST PETERSBURG, FL 33716-1902
(727) 571-1688
(727) 561-0674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME73079
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252278100
—
FL
Enumeration date
09/19/2005
Last updated
03/30/2026
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