Provider Demographics
NPI:1194772574
Name:CHEN, MELVIN C (MD)
Entity type:Individual
Prefix:
First Name:MELVIN
Middle Name:C
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 BEE RIDGE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-921-5335
Mailing Address - Fax:941-921-1741
Practice Address - Street 1:3400 BEE RIDGE RD
Practice Address - Street 2:STE 200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-921-5335
Practice Address - Fax:941-921-1741
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME44648207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL042189800Medicaid
FL042189800Medicaid
FL58444ZMedicare ID - Type Unspecified
FL0928070001Medicare NSC