Healthcare Provider Details

I. General information

NPI: 1215028410
Provider Name (Legal Business Name): KHIN H LWIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NW 70 AVENUE SUITE # 107
PLANTATION FL
33317
US

IV. Provider business mailing address

1082 NW 96 AVENUE
PLANTATION FL
33322
US

V. Phone/Fax

Practice location:
  • Phone: 954-581-3100
  • Fax: 954-581-7773
Mailing address:
  • Phone: 954-581-3110
  • Fax: 954-581-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME33875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: