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General NPI Number Information
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NPI Number | 1487935003
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Entity Type | Organization
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Legal Business Name | WEN I LIN M.D., P.A.
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 3100 US HIGHWAY 1 S SUITE 2
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-6351
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Country | US
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Telephone | 904-797-2921
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Fax | 904-797-6715
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Provider Business Mailing Address
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Address Line | 3100 US HIGHWAY 1 S SUITE 2
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-6351
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Country | US
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Telephone | 904-797-2921
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Fax | 904-797-6715
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Authorized Official
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Title or Position | OWNER/PHYSICAN
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Name | DR. WEN I LIN
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Credential | M.D.,P.A.
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Telephone | 904-797-2921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0032460
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License Number State | FL
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