Provider Demographics
NPI:1184017402
Name:CHENG, MAN LAI
Entity Type:Individual
Prefix:
First Name:MAN LAI
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 NE 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5477
Mailing Address - Country:US
Mailing Address - Phone:954-536-7156
Mailing Address - Fax:
Practice Address - Street 1:500 NE SPANISH RIVER BLVD
Practice Address - Street 2:SUITE 31
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4515
Practice Address - Country:US
Practice Address - Phone:954-536-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2886171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist