MEDICARE: JIAN HU 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	2084P0800X	Psychiatry Physician	ME112670	FL

General Provider Information

NPI Number	:	1548419971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIAN HU M.D.

Provider Business Mailing Address
First Line	:	1608 SE 3RD AVENUE
Second Line	:	THIRD FLOOR CBO/PBS
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-847-4572
Fax Number	:	954-847-4176

Provider Business Practice Location Address
First Line	:	6401 NORTH FEDERAL HIGHWAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1427
Country	:	US
Telephone Number	:	954-776-8616
Fax Number	:

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

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	10/25/2012

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