1427043926 NPI number — YILI ZHOU MD

Table of content: YILI ZHOU MD (NPI 1427043926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427043926 NPI number — YILI ZHOU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHOU
Provider First Name:
YILI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427043926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5365 W ATLANTIC AVE
Provider Second Line Business Mailing Address:
STE 504
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33484-8194
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-241-9300
Provider Business Mailing Address Fax Number:
561-241-9339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1910 SW 18TH CT
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34471-7857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-629-7011
Provider Business Practice Location Address Fax Number:
352-629-7924
Provider Enumeration Date:
09/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , with the licence number:  ME86840 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00264488/DD9858 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: K8875 . This is a "MEDICARE ID-TYPE UNSPECIF" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 47853 . This is a "BLUE SHIELD PROV #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 287725 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 013362500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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