Basic Information
| Provider Information | |||||||||
| NPI: | 1942628235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAU | ||||||||
| FirstName: | QUYNHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1287 N SEMORAN BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328073530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072739410 | ||||||||
| FaxNumber: | 4076587839 | ||||||||
| Practice Location | |||||||||
| Address1: | 1287 N SEMORAN BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328073530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072739410 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2014 | ||||||||
| LastUpdateDate: | 02/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | ME130746 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207R00000X | ME130746 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.