Basic Information
| Provider Information | |||||||||
| NPI: | 1528456407 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRANCIS CHANDY,M. D. PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6971 W SUNRISE BLVD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333134407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547915900 | ||||||||
| FaxNumber: | 9547917890 | ||||||||
| Practice Location | |||||||||
| Address1: | 6971 W SUNRISE BLVD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333134407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547915900 | ||||||||
| FaxNumber: | 9547917890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2014 | ||||||||
| LastUpdateDate: | 12/31/2014 | ||||||||
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| AuthorizedOfficialLastName: | ABRAHAM | ||||||||
| AuthorizedOfficialFirstName: | JOYCE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9547915900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | ME42291 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center |
ID Information
| ID | Type | State | Issuer | Description | 045804000 | 05 | FL | MEDICAID |