Provider Demographics
NPI:1295742476
Name:TUN, THET LIN (MD)
Entity type:Individual
Prefix:DR
First Name:THET
Middle Name:LIN
Last Name:TUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1300 36TH ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4898
Mailing Address - Country:US
Mailing Address - Phone:772-562-3960
Mailing Address - Fax:772-562-3969
Practice Address - Street 1:1300 36TH ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4898
Practice Address - Country:US
Practice Address - Phone:772-562-3960
Practice Address - Fax:772-562-3969
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 97641208M00000X
FLME97641207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91209OtherBCBS OF FL
AG992UMedicare PIN
FLP00471711Medicare PIN
FL91209OtherBCBS OF FL