Individual provider Active NPI

Edwin Kyung Chung, MD

  • Internal Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1104841360
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME124752 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
NPI assigned
Jul 12, 2006
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X ME124752 FL
Internal Medicine Physician 207R00000X ME124752 FL Primary
Hospitalist Physician 208M00000X ME124752 FL
Hypertension Specialist Physician 207RH0005X ME124752 FL

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

2343 Aaron St
Port Charlotte, FL 33952-5305
Phone (855) 979-5700

Other practice location 2

290 Nicholas Pkwy NW Ste 1
Cape Coral, FL 33991-3804
Phone (239) 573-1152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924000475 FL Practitioner - Internal MedicinePractitioner - Nephrology 2163336520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
State University of Ny Upstate Medical University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-9000

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (941) 261-9000

2852 Tamiami TRL
Suite 1
Port Charlotte, FL 33952-5100
Phone (941) 505-8720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME124752FLMDHypertension Specialist Physician
53687CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince May 1, 2025 Accepting new patients
Florida Kidney Physicians , LLC Single Specialty CurrentSince Apr 27, 2025 Accepting new patients
Hospital Medicine Services of FL, LLC Single Specialty CurrentSince Apr 1, 2023 Accepting new patients
Florida Kidney Physicians, LLC Single Specialty CurrentSince Apr 27, 2025 Accepting new patients
Millennium Physician Group LLC Single Specialty CurrentSince May 1, 2025 Accepting new patients
Balbir Singh, MD, Inc. Nephrology Past Accepting new patients
Advanced Intergrated Medicine Inc Single Specialty PastSince Aug 30, 2020 Accepting new patients
Community Hospitalist Medical Group Inc. Single Specialty Past Accepting new patients
Practice of Dr. Edwin Chung Single Specialty Past Accepting new patients

Locations

700 Medical Blvd
Englewood, FL 34223
Phone (941) 473-5001

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

2852 Tamiami Trl
Ste 1
Port Charlotte, FL 33952

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

2343 Aaron St
Pt Charlotte, FL 33952
Phone (855) 979-5700

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: edwin.chung.1@4290.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1104841360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2343 Aaron St",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339525305",
            "country_code": "US",
            "telephone_number": "855-979-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Nicholas Pkwy NW Ste 1",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339913804",
            "country_code": "US",
            "telephone_number": "239-573-1152",
            "fax_number": "239-573-1360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "EDWIN",
        "middle_name": "KYUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME124752",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME124752",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME124752",
            "primary": false
        },
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "FL",
            "license": "ME124752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.