Provider Demographics
NPI:1659606465
Name:XU, XIAOTI (MD)
Entity Type:Individual
Prefix:DR
First Name:XIAOTI
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 SW 38TH AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1530
Mailing Address - Country:US
Mailing Address - Phone:786-409-4135
Mailing Address - Fax:786-703-6196
Practice Address - Street 1:3150 SW 38TH AVE SUITE 800
Practice Address - Street 2:AESTHETIC AND RECONSTRUCTIVE SURGEONS
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:786-409-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 114363208200000X, 208600000X
FLME1283952086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery