Basic Information
| Provider Information | |||||||||
| NPI: | 1427043926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHOU | ||||||||
| FirstName: | YILI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5365 W ATLANTIC AVE | ||||||||
| Address2: | STE 504 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334848194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612419300 | ||||||||
| FaxNumber: | 5612419339 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 SW 18TH CT | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344717857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526297011 | ||||||||
| FaxNumber: | 3526297924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 03/29/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | ME86840 | FL | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00264488/DD9858 | 01 | RAILROAD MEDICARE | OTHER | K8875 | 01 | FL | MEDICARE ID-TYPE UNSPECIF | OTHER | 47853 | 01 | FL | BLUE SHIELD PROV # | OTHER | 287725 | 01 | FL | AVMED | OTHER | 013362500 | 05 | FL | MEDICAID |