Look up the most recent NPI and PECOS records

Tian Li

Internal Medicine

Allopathic & Osteopathic Physicians

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Tian Li is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1790247989
Provider Type
Individual
Full Name
Li, Tian
Title
Dr.
Credential
MD,MS

Gender
Female
Sole Proprietor
No
Enumeration Date
4/5/2019
Last Updated
7/7/2023

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RG0100X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME160506 Florida

Tian Li

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Talley, Nicholas Joseph

Cangemi, John

Gubatan, John Mark Bugarin

Rodriguez, Andrea

Bouras, Ernest

Wolfsen, Herbert

Raimondo, Massimo

Koop, Andree Hermes

Chase, Robert Christopher

Loeb, David