Provider Demographics
NPI:1326010372
Name:LE, MINH Q (MD)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:Q
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 44004
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4004
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:3101 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 102
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2790
Practice Address - Country:US
Practice Address - Phone:904-737-1171
Practice Address - Fax:904-376-4107
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2016-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME36771207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080178341OtherRAILROAD MEDICARE
D63781Medicare UPIN
FL080178341OtherRAILROAD MEDICARE