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Individual

JASON CHUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 615-7848
(913) 341-5797
Mailing address
PO BOX 23605, TAMPA, FL 33623-3605
(888) 533-0566
(913) 341-5797

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
57.010449
OH
207L00000X
Anesthesiology Physician
Primary
ME104807
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146Q4
BCBS
FL
01
P00776737
RAILROAD
FL
Enumeration date
04/13/2007
Last updated
02/04/2010
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