Provider Demographics
NPI:1316087075
Name:LIANG, JENNIFER Y (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:Y
Last Name:LIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-753-7870
Mailing Address - Fax:954-752-0032
Practice Address - Street 1:700 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7008
Practice Address - Country:US
Practice Address - Phone:954-753-7870
Practice Address - Fax:954-752-0032
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050185208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062368700Medicaid
FLME0050185OtherMEDICAL LICENSE
FLBL1119711OtherDEA