MEDICARE: DR. MARILYN YOUNG LIU MD

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	207V00000X	Obstetrics & Gynecology Physician	ME38652	FL

General Provider Information

NPI Number	:	1760575740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN YOUNG LIU MD

Provider Business Mailing Address
First Line	:	9009 LIGON COURT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3602
Country	:	US
Telephone Number	:	239-481-2355
Fax Number	:	239-481-9484

Provider Business Practice Location Address
First Line	:	9009 LIGON CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3602
Country	:	US
Telephone Number	:	239-481-2355
Fax Number	:	239-481-9484

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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