MEDICARE: DR. QILIN LU M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME147426	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467749119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QILIN LU M.D

Provider Business Mailing Address
First Line	:	13172 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2406
Country	:	US
Telephone Number	:	813-374-8981
Fax Number	:

Provider Business Practice Location Address
First Line	:	13172 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2406
Country	:	US
Telephone Number	:	813-374-8981
Fax Number	:	813-521-7422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	08/15/2024

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Directions to “ DR. QILIN LU M.D” Practice Location

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