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General NPI Number Information
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NPI Number | 1811945421
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Entity Type | Individual
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Provider Name | LILY TAN-PINDELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 3663 S MIAMI AVE EMERGENCY DPT
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City | MIAMI
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State | FL
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Zip | 33133-4253
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Country | US
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Telephone | 954-649-5459
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Fax |
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Provider Business Mailing Address
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Address Line | 9268 SANDY RUN RD
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City | JUPITER
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State | FL
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Zip | 33478-6986
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Country | US
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Telephone | 954-649-5459
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA3079
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2177
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License Number State | FL
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