MEDICARE: XI LIANG

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	225700000X	Massage Therapist	MA77515	FL

General Provider Information

NPI Number	:	1417892704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XI LIANG

Provider Business Mailing Address
First Line	:	17181 FALLKIRK AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33954-1502
Country	:	US
Telephone Number	:	352-327-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 CROSS ST UNIT 1108
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-5551
Country	:	US
Telephone Number	:	941-655-8513
Fax Number	:

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

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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Directions to “ XI LIANG ” Practice Location

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