1487283255 NPI number — DR. MITCHEL YONG ZHANG

Table of content: DR. MITCHEL YONG ZHANG (NPI 1487283255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487283255 NPI number — DR. MITCHEL YONG ZHANG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHANG
Provider First Name:
MITCHEL
Provider Middle Name:
YONG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZHANG
Provider Other First Name:
MITCHELL
Provider Other Middle Name:
YONG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1487283255
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
655 WEST 8TH STREET
Provider Second Line Business Mailing Address:
CARDIOVASCULAR CENTER, 5TH FLOOR AMBULATORY CARE CENTER
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-244-3932
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 W 8TH ST FL CENTER5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32209-6511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-244-3932
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2020

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: TRN30845 , 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)





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