Provider Demographics
NPI:1851591002
Name:NI, BO-SHIH (L AC)
Entity Type:Individual
Prefix:
First Name:BO-SHIH
Middle Name:
Last Name:NI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1250 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5383
Mailing Address - Country:US
Mailing Address - Phone:321-757-9731
Mailing Address - Fax:321-757-5069
Practice Address - Street 1:1250 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5383
Practice Address - Country:US
Practice Address - Phone:321-757-9731
Practice Address - Fax:321-757-5069
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP356171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist