Individual
DR. LIAN JEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO PA
Contact information
Practice address
3089 TAMIAMI TRAIL, SUITE B, PORT CHARLOTTE, FL 33952
(941) 627-9768
(941) 627-2785
Mailing address
3089 TAMIAMI TRAIL, SUITE B, PORT CHARLOTTE, FL 33952
(941) 627-9768
(941) 627-2785
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS7724
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273460500
—
FL
01
—
49234
BCBS
FL
Enumeration date
08/28/2005
Last updated
05/09/2013
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