Healthcare Provider Details

I. General information

NPI: 1891735544
Provider Name (Legal Business Name): JIMMY CHIH-MENG HUANG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 45TH ST
WEST PALM BEACH FL
33407
US

IV. Provider business mailing address

1150 45TH ST
WEST PALM BEACH FL
33407-2361
US

V. Phone/Fax

Practice location:
  • Phone: 561-514-5300
  • Fax: 561-514-5538
Mailing address:
  • Phone: 561-514-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS 8761
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: