Organization
CARLOS CHANG MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS CHANG MD (OWNER)
(352) 343-0053
Entity
Organization
Contact information
Practice address
1932 SALK AVE, TAVARES, FL 32778
(352) 343-0053
(352) 343-0059
Mailing address
PO BOX 1363, MT DORA, FL 32756
(352) 343-0053
(352) 343-0059
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME71903
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME71903
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251269602
—
FL
Enumeration date
07/05/2006
Last updated
06/24/2008
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