Chong, Nicole Marie

Chong, Nicole Marie is an individual health care provider with primary practice located at 1613 Nw 136Th Ave Suite 200, Sunrise FL 33323-2853. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Chong, Nicole Marie can be contacted via phone (800) 437-2672.

Contact Information

Primary practice address
1613 Nw 136Th Ave Suite 200 Sunrise FL 33323-2853
Phone: (800) 437-2672
Fax: (281) 851-1416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA03403 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9101662 Florida

Profile Details

NPI number 1063413748
LBN Legal business name Chong, Nicole Marie
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Sep 6th, 2019 - about 5 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 1063413748 NPPES
Other P00458829 RR MCR
MEDICAID 291078100 RR MCR

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