Provider Demographics
NPI:1902926454
Name:CHEN, YONGJIAN (AP)
Entity Type:Individual
Prefix:
First Name:YONGJIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-1800
Mailing Address - Country:US
Mailing Address - Phone:727-688-0410
Mailing Address - Fax:
Practice Address - Street 1:901 N HERCULES AVE STE F
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2031
Practice Address - Country:US
Practice Address - Phone:727-442-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist