Provider Demographics
NPI:1801810759
Name:HUANG, HANXIAN (M D)
Entity type:Individual
Prefix:
First Name:HANXIAN
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 CITRUS TOWER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6802
Mailing Address - Country:US
Mailing Address - Phone:352-242-2282
Mailing Address - Fax:352-242-2886
Practice Address - Street 1:3190 CITRUS TOWER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6802
Practice Address - Country:US
Practice Address - Phone:352-242-2282
Practice Address - Fax:352-242-2886
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
066750OtherMED SOLUTION
FL13964OtherBCBS
110244394OtherRR MEDICARE
H54571Medicare UPIN
E6841Medicare ID - Type Unspecified