Healthcare Provider Details

I. General information

NPI: 1205697570
Provider Name (Legal Business Name): XIONGWEI CAO DIPL. O. M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 GATLIN AVE
ORLANDO FL
32806-6908
US

IV. Provider business mailing address

2358 BARONSMEDE CT
WINTER GARDEN FL
34787-4680
US

V. Phone/Fax

Practice location:
  • Phone: 407-851-2533
  • Fax:
Mailing address:
  • Phone: 407-618-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: