Healthcare Provider Details

I. General information

NPI: 1780381970
Provider Name (Legal Business Name): YUNQIN GOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

IV. Provider business mailing address

6747 SPRING RAIN DR
ORLANDO FL
32819-4737
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-2502
  • Fax:
Mailing address:
  • Phone: 407-715-1016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: