Healthcare Provider Details

I. General information

NPI: 1326762790
Provider Name (Legal Business Name): YUAN LIU MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5771 ROOSEVELT BLVD
CLEARWATER FL
33760-3407
US

IV. Provider business mailing address

5771 ROOSEVELT BLVD
CLEARWATER FL
33760-3407
US

V. Phone/Fax

Practice location:
  • Phone: 727-523-2460
  • Fax: 727-523-2370
Mailing address:
  • Phone: 727-523-2460
  • Fax: 727-523-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11021440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: