Provider Demographics
NPI:1598274698
Name:YEN, PEI-CHI (DOM, AP)
Entity type:Individual
Prefix:
First Name:PEI-CHI
Middle Name:
Last Name:YEN
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S VOLUSIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9134
Mailing Address - Country:US
Mailing Address - Phone:386-774-6333
Mailing Address - Fax:
Practice Address - Street 1:3739 LAKE CENTER DR
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2363
Practice Address - Country:US
Practice Address - Phone:352-729-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3785171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist