Provider Demographics
NPI:1811263858
Name:AUNG, SU SANDY (AP)
Entity type:Individual
Prefix:
First Name:SU SANDY
Middle Name:
Last Name:AUNG
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 1:4808 N STATE ROAD 7
Mailing Address - Street 2:APT 105
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3352
Mailing Address - Country:US
Mailing Address - Phone:646-275-9502
Mailing Address - Fax:
Practice Address - Street 1:2300 GLADES RD
Practice Address - Street 2:SUITE 430W
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7386
Practice Address - Country:US
Practice Address - Phone:954-825-3670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3087171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist