Provider Demographics
NPI:1124226949
Name:ZHAO, XIAO QIAN (LMT)
Entity type:Individual
Prefix:
First Name:XIAO
Middle Name:QIAN
Last Name:ZHAO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 771721
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32877-1721
Mailing Address - Country:US
Mailing Address - Phone:407-761-1534
Mailing Address - Fax:407-343-6116
Practice Address - Street 1:806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4564
Practice Address - Country:US
Practice Address - Phone:407-343-6111
Practice Address - Fax:407-343-6116
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM42050225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA 42050OtherMASSAGE THERAPIST