Provider Demographics
NPI:1871533893
Name:YEN, KENNETH TSU-CHING (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:TSU-CHING
Last Name:YEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 SEMINOLE BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3239
Mailing Address - Country:US
Mailing Address - Phone:727-306-5700
Mailing Address - Fax:727-306-5756
Practice Address - Street 1:11200 SEMINOLE BLVD STE 306
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778
Practice Address - Country:US
Practice Address - Phone:727-306-5700
Practice Address - Fax:727-306-5756
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76921207RC0200X, 207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2345576OtherCIGNA
FL44960OtherBCBS OF FLORIDA
FL1858625OtherUNITED
FLO00897233OtherRAILROAD MEDICARE
FL7696904OtherAETNA
FL1858625OtherUNITED
FL7696904OtherAETNA