Provider Demographics
NPI:1437333713
Name:QIAN, KAIFENG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KAIFENG
Middle Name:
Last Name:QIAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16244 S MILITARY TRL STE 140
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6505
Mailing Address - Country:US
Mailing Address - Phone:561-638-7801
Mailing Address - Fax:561-638-6114
Practice Address - Street 1:16244 S MILITARY TRL STE 140
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6505
Practice Address - Country:US
Practice Address - Phone:561-638-7801
Practice Address - Fax:561-638-6114
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-22
Last Update Date:2007-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG62242Medicare UPIN
FL41994AMedicare PIN