Individual provider · Type 1 NPI

Nicole Marie Chong, PA

Medical Physician Assistant · Sunrise, FL

NPI number 1063413748 Active

Practice location

1613 NW 136th Ave, Suite 200
Sunrise, FL 33323-2853

Fax (281) 851-1416

Mailing address

11249 Brandywine Lake Way
Boynton Beach, FL 33473-4891

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA03403 (TX)
Medical Physician Assistant Primary 363AM0700XPA9101662 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1063413748

Nicole Marie Chong, PA's National Provider Identifier is 1063413748, issued on Aug 3, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Sunrise, FL. The record was last updated on Sep 6, 2019.