Carisse Calandra Fanchon Chin
Nurse Practitioner, Family in South Miami, FL. Individual provider (NPI-1).
NPI number1972309540
StatusActive
Last updated in NPPESFeb 24, 2025
Details
- NPI
- 1972309540
- Entity type
- Individual (NPI-1)
- Name
- Carisse Calandra Fanchon Chin
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 24, 2025
- Certification date
- Feb 24, 2025
- Last updated
- Feb 24, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11035995 | FL | Yes |
Practice location
6200 Sw 73rd StSouth Miami, FL 33143-4679
Phone 786-662-4000
Mailing address
11260 Sw 71st LnMiami, FL 33173-1969
Phone 786-973-1741
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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