Provider Demographics
NPI:1700193265
Name:LI, MELINDA CHI-CHING
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:CHI-CHING
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 2431
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33008-2431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5830 CORAL RIDGE DR STE 120
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3388
Practice Address - Country:US
Practice Address - Phone:888-308-1147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14273225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist