Provider Demographics
NPI:1831522366
Name:LU, MARVIN LOUIS ROY YAP (MD)
Entity type:Individual
Prefix:DR
First Name:MARVIN LOUIS ROY
Middle Name:YAP
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5157
Mailing Address - Country:US
Mailing Address - Phone:386-615-1521
Mailing Address - Fax:386-673-2787
Practice Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 301
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5157
Practice Address - Country:US
Practice Address - Phone:386-615-1521
Practice Address - Fax:386-673-2787
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD458548207R00000X
PAMT203514390200000X
FLME161538207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program