Provider Demographics
NPI:1477748028
Name:LI, ERQIANG (PHD, LAC, DOM)
Entity Type:Individual
Prefix:DR
First Name:ERQIANG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:PHD, LAC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 N ARMENIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7507
Mailing Address - Country:US
Mailing Address - Phone:813-932-2610
Mailing Address - Fax:813-932-2610
Practice Address - Street 1:9710 N ARMENIA AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7507
Practice Address - Country:US
Practice Address - Phone:813-932-2610
Practice Address - Fax:813-932-2610
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1526171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2181984OtherMHBP
FL6144760OtherCIGNA
FL612722900OtherOWCP
FLC0953OtherBCBS
FL342893OtherAV MED