Individual
LIN LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 824-4990
(904) 824-2226
Mailing address
PO BOX 3543, ST AUGUSTINE, FL 32085-3543
(904) 824-4990
(904) 824-2226
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME96974
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I68030
UPIN NUMBER
FL
01
—
P00364189
RAILRAOD MEDICARE
FL
Enumeration date
09/20/2006
Last updated
02/18/2008
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