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:
Health care specialties
Specialty | Code | License # | 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 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063413748 | NPPES |
Other | P00458829 | RR MCR | |
MEDICAID | 291078100 | RR MCR |
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