MEDICARE: DR. QIXIA HUANG M.D.

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	207R00000X	Internal Medicine Physician	ME78764	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215039870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QIXIA HUANG M.D.

Provider Business Mailing Address
First Line	:	1301 PLANTATION ISLAND DR S STE 102A
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-3109
Country	:	US
Telephone Number	:	904-471-5626
Fax Number	:	904-461-8796

Provider Business Practice Location Address
First Line	:	1301 PLANTATION ISLAND DR S STE 102A
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-3109
Country	:	US
Telephone Number	:	904-471-5626
Fax Number	:	904-461-8796

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

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. QIXIA HUANG M.D.” Practice Location

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