Provider Demographics
NPI:1508403148
Name:QIN, XIN
Entity Type:Individual
Prefix:
First Name:XIN
Middle Name:
Last Name:QIN
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 1:12357 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5428
Mailing Address - Country:US
Mailing Address - Phone:305-891-2888
Mailing Address - Fax:954-626-0396
Practice Address - Street 1:12357 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5428
Practice Address - Country:US
Practice Address - Phone:305-891-2888
Practice Address - Fax:954-626-0396
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4102171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist