Provider Demographics
NPI:1730244211
Name:LI, DAOFANG (AP, PHD)
Entity type:Individual
Prefix:DR
First Name:DAOFANG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:AP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 CONROY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-3719
Mailing Address - Country:US
Mailing Address - Phone:407-420-4051
Mailing Address - Fax:407-420-4051
Practice Address - Street 1:5385 CONROY RD STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-3719
Practice Address - Country:US
Practice Address - Phone:407-420-4051
Practice Address - Fax:407-420-4051
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP0000408171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP0000408OtherACUPUNCTURE PHYSICIAN