Individual
KE LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD60909995
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME148836
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
ME148836
FL
Other
Enumeration date
02/15/2013
Last updated
04/05/2021
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