MEDICARE: YNGE LJUNG AP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	650	FL

General Provider Information

NPI Number	:	1003872557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YNGE LJUNG AP

Provider Business Mailing Address
First Line	:	1915 NE 45TH ST
Second Line	:	SUITE # 202
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-5199
Country	:	US
Telephone Number	:	954-667-6637
Fax Number	:	954-667-6629

Provider Business Practice Location Address
First Line	:	1915 NE 45TH ST
Second Line	:	SUITE # 202
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-5199
Country	:	US
Telephone Number	:	954-667-6637
Fax Number	:	954-667-6629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	01/25/2012

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