Provider Demographics
NPI:1578024576
Name:DR YANG ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:DR YANG ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YIWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-222-0371
Mailing Address - Street 1:7735 GREEN MOUNTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5277
Mailing Address - Country:US
Mailing Address - Phone:352-222-0371
Mailing Address - Fax:
Practice Address - Street 1:1200 N CENTRAL AVE STE 213
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4440
Practice Address - Country:US
Practice Address - Phone:407-864-8718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-31
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1831210012OtherNPI