QIXIA HUANG, M.D., P.A.
Ambulatory Health at Plantation Island Dr, Saint Augustine, FL

License number
Florida ME78764
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. QIXIA HUANG M.D.
Title: PRESIDENT
Phone: (904) 471-5626
Address
Address
1301 Plantation Island Dr S STE 102A, Saint Augustine, FL 32080
National Provider ID: 1467649632
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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QIXIA HUANG, M.D., PA

Saint Augustine, FL

Registration:
Nov 24, 2003
Addresses:
1301 Plantation Is Dr S UNIT 102A, Saint Augustine, FL 32080 (Physical)
58 Magnolia Dunes Cir, Saint Augustine, FL 32080 (Mailing)
State ID:
P03000138723
Business type:
Florida Profit Corporation
President, Treasurer, Director:
Qixia M.d. Huang (President, Treasurer, Director), 1301 Plantation Is Dr S UNIT 102A, Saint Augustine, FL 32080 (Physical)
Agent:
Qixia Huang,1301 Plantation Is Dr S UNIT 102A, Saint Augustine, FL 32080 (Physical)
EIN:
20-0484743

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