Provider Demographics
NPI:1528456407
Name:FRANCIS CHANDY,M. D. PA
Entity type:Organization
Organization Name:FRANCIS CHANDY,M. D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-791-5900
Mailing Address - Street 1:6971 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4407
Mailing Address - Country:US
Mailing Address - Phone:954-791-5900
Mailing Address - Fax:954-791-7890
Practice Address - Street 1:6971 W SUNRISE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4407
Practice Address - Country:US
Practice Address - Phone:954-791-5900
Practice Address - Fax:954-791-7890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42291261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045804000Medicaid