Provider Demographics
NPI:1396771861
Name:NAGOSHI, YING LU (MD)
Entity type:Individual
Prefix:DR
First Name:YING
Middle Name:LU
Last Name:NAGOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YING
Other - Middle Name:LU
Other - Last Name:NAGOSHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-0335
Mailing Address - Fax:352-265-0655
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:BOX 100371
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0371
Practice Address - Country:US
Practice Address - Phone:352-265-0335
Practice Address - Fax:352-265-0655
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82730207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G91761Medicare UPIN
FL01170ZMedicare PIN