Provider Demographics
NPI:1366738445
Name:LE, QUYCHI H (MD)
Entity type:Individual
Prefix:
First Name:QUYCHI
Middle Name:H
Last Name:LE
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 1:3601 SW 160TH AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6314
Mailing Address - Country:US
Mailing Address - Phone:305-866-7123
Mailing Address - Fax:866-984-4216
Practice Address - Street 1:930 NE DUNCAN RD
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2173
Practice Address - Country:US
Practice Address - Phone:816-229-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016031237208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2500037427OtherBNDD
MO1366738445Medicaid
MO2016031237OtherMO STATE BOARD OF REGISTRATION FOR THE HEALING ARTS