| Alicia Chen MD | |
|
4900 Bayou Blvd Suite 107 Pensacola FL 32503-2525 | |
| (850) 607-6269 | |
| Not Available |
| Full Name | Alicia Chen MD |
|---|---|
| Speciality | Internal Medicine |
| Location | 4900 Bayou Blvd, Pensacola, Florida |
| Authorized Official Name and Position | Alicia L Chen (CEO) |
| Authorized Official Contact | 8506076269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alicia Chen MD 4900 Bayou Blvd Suite 107 Pensacola FL 32503-2525 Ph: (850) 607-6269 | Alicia Chen MD 4900 Bayou Blvd Suite 107 Pensacola FL 32503-2525 Ph: (850) 607-6269 |
| NPI Number | 1174880660 |
|---|---|
| Provider Enumeration Date | 04/20/2012 |
| Last Update Date | 04/20/2012 |
| Medicare PECOS PAC ID | 2264696657 |
|---|---|
| Medicare Enrollment ID | O20120615000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174880660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME80686 (Florida) | Primary |
| Provider Name | Alicia Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598772873 PECOS PAC ID: 9537221908 Enrollment ID: I20081218000267 |
| Provider Name | Jacqueline M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083118350 PECOS PAC ID: 5698100824 Enrollment ID: I20200116002094 |
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