Provider Demographics
NPI:1003279845
Name:CHAN, CATHERINE WINGYUN (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:WINGYUN
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W BROADWAY ST STE 236
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9262
Mailing Address - Country:US
Mailing Address - Phone:321-841-6060
Mailing Address - Fax:321-841-2442
Practice Address - Street 1:1000 W BROADWAY ST STE 236
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9262
Practice Address - Country:US
Practice Address - Phone:321-841-6060
Practice Address - Fax:321-841-2442
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304627207V00000X
FLME176560207VG0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program