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Organization
WEN I LIN M.D., P.A.
Active
Organization
WEN I LIN M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WEN I LIN M.D.,P.A. (OWNER/PHYSICAN)
(904) 797-2921
Entity
Organization
Contact information
Practice address
3100 US HIGHWAY 1 S, SUITE 2, SAINT AUGUSTINE, FL 32086-6351
(904) 797-2921
(904) 797-6715
Mailing address
3100 US HIGHWAY 1 S, SUITE 2, SAINT AUGUSTINE, FL 32086-6351
(904) 797-2921
(904) 797-6715
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0032460
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038135700
—
FL
01
—
406343598
RAILROAD MEDICARE
FL
01
—
55103
BLUECROSS
—
01
—
5819011
AETNA
FL
Enumeration date
09/09/2011
Last updated
09/22/2011
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