MEDICARE: YING SHAN ALTERNATIVE MEDICINE

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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1972157303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YING SHAN ALTERNATIVE MEDICINE

Provider Business Mailing Address
First Line	:	2591 SW 16TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3902
Country	:	US
Telephone Number	:	786-942-5798
Fax Number	:

Provider Business Practice Location Address
First Line	:	2591 SW 16TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3902
Country	:	US
Telephone Number	:	786-942-5798
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ DIRECTOR
Name	:	JULIETTE SHEN
Credential	:
Telephone Number	:	786-942-5798

Provider Enumeration Date	:	07/24/2019
Last Update Date	:	07/24/2019

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