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General NPI Number Information
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NPI Number | 1356395487
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Entity Type | Individual
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Provider Name | SELINA JIA-HWA LIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 3001 EASTLAND BLVD STE 1
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City | CLEARWATER
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State | FL
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Zip | 33761
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Country | US
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Telephone | 833-733-3754
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Fax |
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Provider Business Mailing Address
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Address Line | 407 AVENUE K SE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-4126
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Country | US
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Telephone | 863-294-3504
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Fax | 863-294-8305
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME88250
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License Number State | FL
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