Provider Demographics
NPI:1407138050
Name:SUN, HUA LING IV (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HUA
Middle Name:LING
Last Name:SUN
Suffix:IV
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 AUBURN OAKS RD W.
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218
Mailing Address - Country:US
Mailing Address - Phone:912-396-1866
Mailing Address - Fax:
Practice Address - Street 1:1550 HENDRICKS AVE, SUITE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-434-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2020-02-04
Deactivation Date:2019-01-30
Deactivation Code:
Reactivation Date:2020-01-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist