1053646448 NPI number — CYNTHIA XIN-XIA ZHANG AP

Table of content: CYNTHIA XIN-XIA ZHANG AP (NPI 1053646448)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053646448 NPI number — CYNTHIA XIN-XIA ZHANG AP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHANG
Provider First Name:
CYNTHIA
Provider Middle Name:
XIN-XIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AP
Provider Gender Code:
F

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:
1053646448
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
787 SAINT ALBANS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33486-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-414-0715
Provider Business Mailing Address Fax Number:
954-721-8843

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 LEE WAGENER BLVD
Provider Second Line Business Practice Location Address:
SUITE 356
Provider Business Practice Location Address City Name:
FT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33315-3570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-414-0715
Provider Business Practice Location Address Fax Number:
954-721-8843
Provider Enumeration Date:
10/02/2009

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: 171100000X , with the licence number:  AP 2736 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 175L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 270841141 . This is a "BLUE CROSS INSURANCE PROVIDER REGISTRATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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