MEDICARE: YONG MEI NI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	A1007211	FL
2	207R00000X	Internal Medicine Physician	ME126690	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IU131Z	OTHER	FL	MCARE MD PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073796637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YONG MEI NI MD

Provider Business Mailing Address
First Line	:	3048 DELLCREST PL
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-2302
Country	:	US
Telephone Number	:	407-416-1401
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N ASHLEY DR
Second Line	:	STE 1625
City	:	TAMPA
State	:	FL
Zip	:	33602-4300
Country	:	US
Telephone Number	:	813-289-6597
Fax Number	:	813-289-6592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/14/2016

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Directions to “ YONG MEI NI MD” Practice Location

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