Provider Demographics
NPI:1730570318
Name:VU, IVY (AP)
Entity type:Individual
Prefix:DR
First Name:IVY
Middle Name:
Last Name:VU
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 1:1517 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4710
Mailing Address - Country:US
Mailing Address - Phone:407-325-4577
Mailing Address - Fax:888-487-1880
Practice Address - Street 1:1517 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4710
Practice Address - Country:US
Practice Address - Phone:407-325-4577
Practice Address - Fax:888-487-1880
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3483171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist