Individual
SEUNG JIN YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6117 GUNN HWY, TAMPA, FL 33625-4013
(813) 978-9700
(813) 558-6187
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME123493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014890300
—
FL
01
—
150W5
FLORIDA BLUE
FL
Enumeration date
06/26/2009
Last updated
10/09/2019
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