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General NPI Number Information
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NPI Number | 1386866077
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Entity Type | Individual
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Provider Name | LOAN KIM LAM D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 3609 MADACA LN
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City | TAMPA
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State | FL
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Zip | 33618-2048
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Country | US
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Telephone | 800-991-6117
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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Fax |
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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 | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | PO3302
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | PO3302
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3302
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License Number State | FL
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