Organization
DIANE W CHUNG MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE W CHUNG MD (PRESIDENT)
(904) 421-2119
Entity
Organization
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 421-2119
Mailing address
PO BOX 862056, ORLANDO, FL 32886-2056
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/08/2006
Last updated
09/24/2007
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