Provider Demographics
NPI: | 1912165374 |
---|---|
Name: | CHEN, HSIONG (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | HSIONG |
Middle Name: | |
Last Name: | CHEN |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 11215 METRO PKWY STE 1 |
Mailing Address - Street 2: | |
Mailing Address - City: | FORT MYERS |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33966-1206 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 239-208-2212 |
Mailing Address - Fax: | 239-208-3994 |
Practice Address - Street 1: | 11215 METRO PKWY STE 1 |
Practice Address - Street 2: | |
Practice Address - City: | FORT MYERS |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33966-1206 |
Practice Address - Country: | US |
Practice Address - Phone: | 239-208-2212 |
Practice Address - Fax: | 239-208-3994 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-06-01 |
Last Update Date: | 2025-06-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 2021011453 | 2084N0400X |
PA | MD476131 | 2084N0400X |
MT | 90492 | 2084N0400X |
NH | 21001 | 2084N0400X |
IL | 36119316 | 2084N0400X |
FL | ME147468 | 2084N0400X, 208M00000X |
TX | T3054 | 2084N0400X |
MD | D79395 | 2084N0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist |