Carlos Chang MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME71903 Issued in FL

Legal business name

CARLOS CHANG MD PA

Practice address

1932 Salk Ave
Tavares, FL 32778

Phone

(352) 343-0053

Fax

(352) 343-0059

NPI assigned

Jul 5, 2006

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carlos Chang, MDNPI 1922005016

Title

Owner

Phone

(352) 343-0053

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carlos F Chang, M.D.

  • Internal Medicine Physician
  • Tavares, FL
  • NPI 1922005016
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1598795221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1363",
            "city": "MT DORA",
            "state": "FL",
            "postal_code": "32756",
            "telephone_number": "352-343-0053",
            "fax_number": "352-343-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 SALK AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-343-0053",
            "fax_number": "352-343-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS CHANG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-343-0053",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71903",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME71903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251269602",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.