Healthcare Provider Details

I. General information

NPI: 1407981400
Provider Name (Legal Business Name): PAULA LIN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S OSCEOLA AVE
ORLANDO FL
32806-5419
US

IV. Provider business mailing address

2800 S OSCEOLA AVE
ORLANDO FL
32806-5419
US

V. Phone/Fax

Practice location:
  • Phone: 407-839-3834
  • Fax: 407-839-3834
Mailing address:
  • Phone: 407-839-3834
  • Fax: 407-839-3834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberME90422
License Number StateFL

VIII. Authorized Official

Name: PAULA LIN
Title or Position: OWNER PRESIDENT
Credential: M.D.
Phone: 407-839-3834