MEDICARE: DR. HENRY LIN 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	208000000X	Pediatrics Physician	ME62771	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679569040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY LIN MD

Provider Business Mailing Address
First Line	:	3900 N ANDREWS AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5240
Country	:	US
Telephone Number	:	954-563-4323
Fax Number	:	954-563-2311

Provider Business Practice Location Address
First Line	:	3900 N ANDREWS AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5240
Country	:	US
Telephone Number	:	954-563-4323
Fax Number	:	954-563-2311

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/22/2008

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