Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME97641 | FL |
N | 111NI0900X | Internist | ME97641 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | ME97641 | FL |
NPI | 1295742476 |
---|---|
Provider Name | Dr. Thet Lin Tun |
First Address | Vero Beach, FL 32960-4898 |
Second Address | Vero Beach, FL 32960-4898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 24/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
91209 | BCBS OF FL (01) | FL |