Provider Demographics
NPI:1891735544
Name:HUANG, JIMMY CHIH-MENG (DO)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:CHIH-MENG
Last Name:HUANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 45TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2361
Mailing Address - Country:US
Mailing Address - Phone:561-514-5300
Mailing Address - Fax:
Practice Address - Street 1:1150 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-514-5300
Practice Address - Fax:561-514-5538
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271399300Medicaid
FL271399300Medicaid
FL48028YMedicare PIN
FL48028YMedicare Oscar/Certification