Organization
MELVIN C. LU, M.D., LLC
Active
Other names
Lien & Lu, M.D's P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN C LU MD (OWNER/PRESIDENT)
(352) 596-4401
Entity
Organization
Contact information
Practice address
10133 CORTEZ BLVD., BROOKSVILLE, FL 34613-6385
(352) 596-4401
(352) 596-4431
Mailing address
10133 CORTEZ BLVD., BROOKSVILLE, FL 34613-6385
(352) 596-4401
(352) 596-4431
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME70999
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME70999
FL
207ND0900X
Dermatopathology Physician
ME70999
FL
207NS0135X
Procedural Dermatology Physician
ME70999
FL
363A00000X
Physician Assistant
PA2766
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38300
BCBS GROUP NUMBER
—
01
—
38300A
BCBS GROUP NUMBER
—
01
—
CI5866
MEDICARE RAILROAD
—
Enumeration date
10/05/2007
Last updated
04/28/2014
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