Individual ProviderYun FanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address11325 Lake Underhill Rd Ste 102, Orlando, FL 32825-5090(407) 275-0002(646) 577-5291PECOS EnrollmentBased on the most recent information from CMS, provider Yun Fan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1043052590Provider TypeIndividualFull NameFan, YunCredentialNPGenderFemaleSole ProprietorNoEnumeration Date6/6/2024Last Updated6/6/2024Contact InformationPractice LocationPractice Address11325 Lake Underhill Rd Ste 102, Orlando, FL 32825-5090Phone(407) 275-0002FaxUnlisted FaxMailing LocationMailing Address2475 Cedar Chase Cv, Oviedo, FL 32765-9065Phone(646) 577-5291FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11033208Florida