Healthcare Provider Details

I. General information

NPI: 1245303619
Provider Name (Legal Business Name): MING-SHUN CHENG PT, MS, SCD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: M. SAMUEL CHENG PT, MS, SCD

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

266 SW 159TH TER
SUNRISE FL
33326-2268
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1273
  • Fax:
Mailing address:
  • Phone: 954-475-1833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25530
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15597
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number021997-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: