| Carlos Chang Md Pa | |
|
1932 Salk Ave Tavares FL 32778 | |
| (352) 343-0053 | |
| (352) 343-0059 |
| Full Name | Carlos Chang Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1932 Salk Ave, Tavares, Florida |
| Authorized Official Name and Position | Carlos Chang (OWNER) |
| Authorized Official Contact | 3523430053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlos Chang Md Pa Po Box 1363 Mt Dora FL 32756 Ph: (352) 343-0053 | Carlos Chang Md Pa 1932 Salk Ave Tavares FL 32778 Ph: (352) 343-0053 |
| NPI Number | 1598795221 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 06/24/2008 |
| Medicare PECOS PAC ID | 0446211130 |
|---|---|
| Medicare Enrollment ID | O20041026000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598795221 | NPI | - | NPPES |
| 251269602 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME71903 (Florida) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | ME71903 (Florida) | Secondary |
| Provider Name | Carlos F Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922005016 PECOS PAC ID: 4981665684 Enrollment ID: I20041027000640 |
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