=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962669192
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALEC YEN NIEN LUI
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2008
-----------------------------------------------------
Last Update Date | 10/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 275 18TH ST SUITE 102
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-562-6818
-----------------------------------------------------
Fax | 772-299-3653
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 275 18TH ST SUITE 102
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-562-6818
-----------------------------------------------------
Fax | 772-299-3653
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALEC YEN NIEN LUI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 772-562-6818
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------