Provider Demographics
NPI:1730326166
Name:RAMON A. CHIONG, D.O., P.A.
Entity type:Organization
Organization Name:RAMON A. CHIONG, D.O., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIONG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:772-460-0321
Mailing Address - Street 1:2100 NEBRASKA AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4831
Mailing Address - Country:US
Mailing Address - Phone:772-460-0321
Mailing Address - Fax:772-460-0332
Practice Address - Street 1:2100 NEBRASKA AVE STE 113
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4831
Practice Address - Country:US
Practice Address - Phone:772-460-0321
Practice Address - Fax:772-460-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256169700Medicaid
FLG91258Medicare UPIN