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NPI Code Detail

MEDICARE: DR. MARY M LI M.D.

MEDICARE:  DR. MARY M LI  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RX0202XMedical Oncology PhysicianME84859FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00468395OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275503971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY M LI M.D.
Provider Business Mailing Address
First Line : 4371 VERONICA S SHOEMAKER BLVD
Second Line : ATTN: CREDENTIAL DEPT
City : FORT MYERS
State : FL
Zip : 33916-2216
Country : US
Telephone Number : 239-274-8200
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 7154 MEDICAL CENTER DR
Second Line :
City : SPRING HILL
State : FL
Zip : 34608-1329
Country : US
Telephone Number : 352-596-1926
Fax Number : 352-597-2154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 08/10/2022

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