MEDICARE: YIFAN LI D.O.

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	2085R0001X	Radiation Oncology Physician	04977	KY
2	2085R0001X	Radiation Oncology Physician	OS23216	FL

General Provider Information

NPI Number	:	1942654314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIFAN LI D.O.

Provider Business Mailing Address
First Line	:	250 PARK ST
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42101-1760
Country	:	US
Telephone Number	:	270-781-7178
Fax Number	:	270-796-5516

Provider Business Practice Location Address
First Line	:	380 CELEBRATION PL # 100
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-4606
Country	:	US
Telephone Number	:	407-303-4678
Fax Number	:	407-303-4606

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

Provider Enumeration Date	:	04/21/2016
Last Update Date	:	03/18/2026

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Directions to “ YIFAN LI D.O.” Practice Location

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