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Individual

JEROLD NORMAN CHIP I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
206 N FLORIDA AVE, LAKELAND, FL 33801-4902
(863) 209-7003
(863) 284-3083
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5742
(305) 831-4761
(305) 831-4761

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301094726
MI
207RC0000X
Cardiovascular Disease Physician
01019735A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
ME123575
FL

Other

Enumeration date
05/04/2009
Last updated
02/21/2017
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