Individual ProviderCarisse Calandra Fanchon ChinNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6200 SW 73rd St, South Miami, FL 33143-4679(786) 662-4000(786) 973-1741PECOS EnrollmentBased on the most recent information from CMS, provider Carisse Calandra Fanchon Chin does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:37 AM.Profile DetailsProvider ID1972309540Provider TypeIndividualFull NameChin, Carisse Calandra FanchonGenderFemaleSole ProprietorYesEnumeration Date2/24/2025Last Updated2/24/2025Contact InformationPractice LocationPractice Address6200 SW 73rd St, South Miami, FL 33143-4679Phone(786) 662-4000FaxUnlisted FaxMailing LocationMailing Address11260 SW 71st Ln, Miami, FL 33173-1969Phone(786) 973-1741FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11035995Florida