Provider Demographics
NPI:1336489368
Name:CHANG CHIO, LUIS ALEJANDRO (AP)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALEJANDRO
Last Name:CHANG CHIO
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 SW 17TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2707
Mailing Address - Country:US
Mailing Address - Phone:786-970-2737
Mailing Address - Fax:786-221-9606
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE: 448
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:786-970-2737
Practice Address - Fax:786-221-9606
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3219171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist