Healthcare Provider Details

I. General information

NPI: 1366732703
Provider Name (Legal Business Name): ZUNLI MO PHD, OMD, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N. KENDALL DR MIAMI CANCER INSTITUTE
MIAMI FL
33176-2118
US

IV. Provider business mailing address

42 FOUR SEASONS SHOPPING CTR STE 133
CHESTERFIELD MO
63017-3100
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-2000
  • Fax:
Mailing address:
  • Phone: 636-795-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4025
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: