Provider Demographics
NPI:1124570585
Name:LI, KUNNING (AP)
Entity Type:Individual
Prefix:DR
First Name:KUNNING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3293
Mailing Address - Country:US
Mailing Address - Phone:407-458-9659
Mailing Address - Fax:
Practice Address - Street 1:2135 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119
Practice Address - Country:US
Practice Address - Phone:386-760-2112
Practice Address - Fax:386-760-8722
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3495171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist