Provider Demographics
NPI:1710920038
Name:LIU, ALEXANDER ONG JR (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:ONG
Last Name:LIU
Suffix:JR
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:PO BOX 640524
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34464-0524
Mailing Address - Country:US
Mailing Address - Phone:352-746-2525
Mailing Address - Fax:352-746-4141
Practice Address - Street 1:2 WEST LEMON STREET
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465
Practice Address - Country:US
Practice Address - Phone:352-746-2525
Practice Address - Fax:352-746-4141
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21049OtherBCBS
G18658Medicare UPIN
21049Medicare ID - Type Unspecified