Healthcare Provider Details

I. General information

NPI: 1942072053
Provider Name (Legal Business Name): YUEXIN HUANG PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N 40TH AVE
HOLLYWOOD FL
33021-1860
US

IV. Provider business mailing address

3801 N 40TH AVE
HOLLYWOOD FL
33021-1860
US

V. Phone/Fax

Practice location:
  • Phone: 347-347-3132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number050777
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: