Provider Demographics
NPI:1457404006
Name:HE, HONGJIAN (AP)
Entity type:Individual
Prefix:DR
First Name:HONGJIAN
Middle Name:
Last Name:HE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N HERCULES AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2031
Mailing Address - Country:US
Mailing Address - Phone:727-442-9220
Mailing Address - Fax:727-445-9799
Practice Address - Street 1:901 N HERCULES AVE
Practice Address - Street 2:SUITE F
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2031
Practice Address - Country:US
Practice Address - Phone:727-442-9220
Practice Address - Fax:727-445-9799
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP00028171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC0064OtherBLUE CROSS PROVIDER