Provider Demographics
NPI:1841400991
Name:HUA, DONG
Entity Type:Individual
Prefix:
First Name:DONG
Middle Name:
Last Name:HUA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E BROWARD BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3529
Mailing Address - Country:US
Mailing Address - Phone:786-223-9665
Mailing Address - Fax:
Practice Address - Street 1:100 E BROWARD BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3529
Practice Address - Country:US
Practice Address - Phone:786-223-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2225171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist