MEDICARE: DR. JIANYU LI MD

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	ME133391	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	:	1508157983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIANYU LI MD

Provider Business Mailing Address
First Line	:	499 E CENTRAL PKWY STE 205
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3450
Country	:	US
Telephone Number	:	407-960-6709
Fax Number	:	407-960-7627

Provider Business Practice Location Address
First Line	:	499 E CENTRAL PKWY STE 205
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3450
Country	:	US
Telephone Number	:	407-960-6709
Fax Number	:	407-960-6727

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

Provider Enumeration Date	:	04/20/2011
Last Update Date	:	03/07/2023

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