Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME134134 | FL |
NPI | 1083904593 |
---|---|
Provider Name | Chun Kevin Yang |
First Address | St Petersburg, FL 33705-1347 |
Second Address | St Petersburg, FL 33705-1347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 11/06/2019 |