Healthcare Provider Details

I. General information

NPI: 1831514124
Provider Name (Legal Business Name): YINGJUAN DONG L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3935 N FEDERAL HWY
POMPANO BEACH FL
33064-6042
US

IV. Provider business mailing address

3935 N FEDERAL HWY
POMPANO BEACH FL
33064-6042
US

V. Phone/Fax

Practice location:
  • Phone: 954-972-6888
  • Fax: 954-827-0201
Mailing address:
  • Phone: 954-972-6888
  • Fax: 954-827-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: