Individual
MR. JINGTAO CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
13330 USF LAUREL DR, 3RD FLOOR, TAMPA, FL 33612-6601
(813) 974-2201
(813) 974-7567
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9209361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001933200
—
FL
01
—
Y03VG
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/10/2009
Last updated
03/22/2021
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