Provider Demographics
NPI:1518330943
Name:LIU, SHENGHSI KIMBERLY (DOM)
Entity Type:Individual
Prefix:
First Name:SHENGHSI
Middle Name:KIMBERLY
Last Name:LIU
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:SHENG HSI
Other - Middle Name:KIMBERLY
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOM
Mailing Address - Street 1:5222 ANDRUS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5400
Mailing Address - Country:US
Mailing Address - Phone:407-490-3275
Mailing Address - Fax:
Practice Address - Street 1:5222 ANDRUS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5400
Practice Address - Country:US
Practice Address - Phone:407-490-3275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3653171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist