Provider Demographics
NPI:1275309890
Name:CARDONNE HUNG, SUILIENG
Entity Type:Individual
Prefix:
First Name:SUILIENG
Middle Name:
Last Name:CARDONNE HUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 NW 24TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-8754
Mailing Address - Country:US
Mailing Address - Phone:239-265-3606
Mailing Address - Fax:
Practice Address - Street 1:302 NW 24TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-8754
Practice Address - Country:US
Practice Address - Phone:239-265-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-309650106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty