Individual ProviderFang ChenHospitalistAllopathic & Osteopathic PhysiciansPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205(904) 202-3860(904) 202-1032PECOS EnrollmentBased on the most recent information from CMS, provider Fang Chen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1407193790Provider TypeIndividualFull NameChen, FangCredentialMDGenderFemaleSole ProprietorNoEnumeration Date1/7/2013Last Updated7/10/2024Contact InformationPractice LocationPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205Phone(904) 202-3860Fax(904) 202-3846Mailing LocationMailing AddressPO Box 746638, Atlanta, GA 30374-6638Phone(904) 202-1032Fax(904) 376-4107Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseME138736FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME138736Florida