Chan, Colin

Chan, Colin is an individual health care provider with primary practice located at 12450 Roosevelt Blvd N Suite 101, St Petersburg FL 33716-1902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Chan, Colin can be contacted via phone (727) 571-1688.

Contact Information

Primary practice address
12450 Roosevelt Blvd N Suite 101 St Petersburg FL 33716-1902
Phone: (727) 571-1688
Fax: (727) 572-0900
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME73079 Florida

Profile Details

NPI number 1194710871
LBN Legal business name Chan, Colin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Oct 7th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194710871 NPPES
Florida MEDICAID 252278100

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