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Individual

PHAN QUI LINDSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 554-8093
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
(813) 974-2201

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
001930
GA
208000000X
Pediatrics Physician
ME104413
FL
208M00000X
Hospitalist Physician
Primary
ME104413
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001279500
FL
01
145WE
BLUE CROSS BLUE SHIELD
FL
01
CI805Z
MEDICARE PTAN
FL
Enumeration date
04/29/2008
Last updated
08/23/2016
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