MEDICARE: MR. TUNGSHEN TIEN A.P.

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	171100000X	Acupuncturist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP 2824	OTHER	FL	ACUPUNTURE

General Provider Information

NPI Number	:	1124328299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TUNGSHEN TIEN A.P.

Provider Business Mailing Address
First Line	:	8771 STIRLING RD
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5932
Country	:	US
Telephone Number	:	954-603-1311
Fax Number	:	954-252-5199

Provider Business Practice Location Address
First Line	:	8771 STIRLING RD
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5932
Country	:	US
Telephone Number	:	954-603-1311
Fax Number	:	954-252-5199

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

Provider Enumeration Date	:	10/23/2010
Last Update Date	:	10/23/2010

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