Individual
PENG LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 SW ARCHER RD # 100275, GAINESVILLE, FL 32610-3003
(352) 273-7839
(352) 273-8172
Mailing address
1600 SW ARCHER RD # 100275, GAINESVILLE, FL 32610-0301
(352) 273-7839
(352) 273-8172
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
8437499-1205
UT
207ZH0000X
Hematology (Pathology) Physician
ME132726
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME132726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021081500
—
FL
01
—
IZ523Z
MEDICARE PTAN
—
Enumeration date
07/06/2011
Last updated
07/21/2022
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