Provider Demographics
NPI:1790072593
Name:HSU, JOHN CHENGMING (LAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHENGMING
Last Name:HSU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 N GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8721
Mailing Address - Country:US
Mailing Address - Phone:407-679-5375
Mailing Address - Fax:407-679-5375
Practice Address - Street 1:3402 N GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8721
Practice Address - Country:US
Practice Address - Phone:407-679-5375
Practice Address - Fax:407-679-5375
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2331171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist