Provider Demographics
NPI:1093794026
Name:KING, BO YUNG (OD)
Entity Type:Individual
Prefix:
First Name:BO YUNG
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BO YUNG
Other - Middle Name:
Other - Last Name:KWON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:13625 E. EMERALD COAST PKWY
Mailing Address - Street 2:UNIT 4
Mailing Address - City:INLET BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32461
Mailing Address - Country:US
Mailing Address - Phone:850-427-2002
Mailing Address - Fax:850-696-0393
Practice Address - Street 1:13625 E EMERALD COAST PKWY SUITE 4
Practice Address - Street 2:
Practice Address - City:INLET BEACH
Practice Address - State:FL
Practice Address - Zip Code:32461
Practice Address - Country:US
Practice Address - Phone:850-427-2002
Practice Address - Fax:850-696-0393
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 006520152W00000X
GA002636152W00000X
FLOPC005621152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist