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General NPI Number Information
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NPI Number | 1891742284
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Entity Type | Organization
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Legal Business Name | YILI ZHOU LLC
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 440 SW PERIMETER GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-0497
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Country | US
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Telephone | 386-719-9663
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Fax | 386-719-9662
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Provider Business Mailing Address
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Address Line | 5525 BANANA POINT DR
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City | OKAHUMPKA
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State | FL
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Zip | 34762-3334
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Country | US
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Telephone | 352-629-7011
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Fax | 352-629-7924
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. YILI ZHOU
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Credential | M.D.
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Telephone | 352-629-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME86840
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License Number State | FL
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