MEDICARE: MS. YEE NI SUNG PA-C

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	363A00000X	Physician Assistant	PA9104954	FL

General Provider Information

NPI Number	:	1679708937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YEE NI SUNG PA-C

Provider Business Mailing Address
First Line	:	4513 EXECUTIVE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-9033
Country	:	US
Telephone Number	:	702-521-3683
Fax Number	:

Provider Business Practice Location Address
First Line	:	4513 EXECUTIVE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-9033
Country	:	US
Telephone Number	:	239-598-9327
Fax Number	:	239-598-9384

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

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	05/15/2009

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