MEDICARE: CHI-CHIOU LIU MD PA

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	207Q00000X	Family Medicine Physician	ME0029741	FL

General Provider Information

NPI Number	:	1386952380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHI-CHIOU LIU MD PA

Provider Business Mailing Address
First Line	:	1102 COLONNADES DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-3063
Country	:	US
Telephone Number	:	772-466-0200
Fax Number	:	772-466-2730

Provider Business Practice Location Address
First Line	:	1102 COLONNADES DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-3063
Country	:	US
Telephone Number	:	772-466-0200
Fax Number	:	772-466-2730

Authorized Official
Title or Position	:	OWNER/MD
Name	:	DR. CHI CHIOU LIU
Credential	:	MD
Telephone Number	:	772-466-0200

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	09/24/2010

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