Provider Demographics
NPI:1306301031
Name:FORMOSA DAILY HEALTH LLC
Entity type:Organization
Organization Name:FORMOSA DAILY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YEN TING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:954-940-8682
Mailing Address - Street 1:120 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5321
Mailing Address - Country:US
Mailing Address - Phone:954-781-8264
Mailing Address - Fax:954-301-3778
Practice Address - Street 1:120 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-5321
Practice Address - Country:US
Practice Address - Phone:954-781-8264
Practice Address - Fax:954-301-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center