Individual
DR. AVIS S. CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 396-1630
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME0056181
FL
207LP3000X
Pediatric Anesthesiology Physician
Primary
ME0056181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000446454A
—
GA
05
—
061874800
—
FL
Enumeration date
08/10/2006
Last updated
09/09/2011
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