Provider Demographics
NPI:1891742284
Name:YILI ZHOU LLC
Entity Type:Organization
Organization Name:YILI ZHOU LLC
Other - Org Name:FLORIDA PAIN AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YILI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-629-7011
Mailing Address - Street 1:5525 BANANA POINT DR
Mailing Address - Street 2:
Mailing Address - City:OKAHUMPKA
Mailing Address - State:FL
Mailing Address - Zip Code:34762-3334
Mailing Address - Country:US
Mailing Address - Phone:352-629-7011
Mailing Address - Fax:352-629-7924
Practice Address - Street 1:440 SW PERIMETER GLN
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0497
Practice Address - Country:US
Practice Address - Phone:386-719-9663
Practice Address - Fax:386-719-9662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86840208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265587000Medicaid
FL47853OtherBCBS
P00264488/DD9858OtherRAILROAD MEDICARE
FL009381900Medicaid
FL287725OtherAVMED
FL013362500Medicaid
FL7281245OtherAETNA
FL013362500Medicaid
FL=========OtherBEECHSTREET
FL=========OtherTRICARE
FL=========OtherBEECHSTREET
FL=========OtherUNITED HEALTH CARE
FL265587000Medicaid
FL7491930002Medicare NSC