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NPI Code Detail

MEDICARE: DR. KATHARINE S LUM M.D.

MEDICARE:  DR. KATHARINE S LUM  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
1207VG0400XGynecology PhysicianME004400FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3160040633OTHERFLRAILROAD MEDICARE
4K0449OTHERFLMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
162534OTHERFLBLUE CROSS BLUE SHEILD
210D0952099OTHERFLCLIA NUMBER

General Provider Information

NPI Number : 1467422832
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHARINE S LUM M.D.
Provider Business Mailing Address
First Line : 777 37TH ST STE C101
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-7301
Country : US
Telephone Number : 772-562-6566
Fax Number : 772-562-6570
Provider Business Practice Location Address
First Line : 777 37TH ST STE C101
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-7301
Country : US
Telephone Number : 772-562-6566
Fax Number : 772-562-6570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 05/20/2020

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Directions to “ DR. KATHARINE S LUM M.D.” Practice Location

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